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NURS FPX 4050 Assessment 4 Final Care Coordination Plan TS

NURS FPX 4050 Assessment 4 Final Care Coordination Plan TS

Patient-centered Health Interventions and Timelines

Patient centered and collaborative care practices are becoming an increasingly important aspect of healthcare settings such as Vila Health Hospital to achieve personal recovery outcomes for mentally ill patients. Successful patient centered planning is crucial because its implementation is often ignored by the professionals. For example, communicating evidence to mentally sick patients suffering from substance abuse and depression and their families is a vital challenge in improving a healthcare system focused on patient-centered outcomes (Bulmer, 2021). Patients are often bombarded with many diagnoses and information that have no background or education in understanding such crucial messages. As a result, mental health patients are not able to interpret that information presented by nurses and physicians in Vila Health Hospital. Moreover, a similar issue is that many patients interpret this information as conflicting advice. Therefore, there is a dire need for the nurses to incorporate patient-centered health interventions and timelines and rethink how they are going to share information with patients. Some patients and their loved ones are admitted with mental health issues beyond their control. Understanding the mental health treatment for those patients and their families can be a challenging task seeking support for the first time. Hence, it is extremely vital to recognize that nurses know more about psychological conditions and care to improve patients’ wellness. 

Patient-centered approaches and interventions involve providing care that is respectful for all mentally sick patients and also match their needs and values (Brooks, 2018). This approach helps to build a foundation of a better relationship. The research shows that nurses should understand the patients’ perspectives in their planning of coordinated care during admission of psychiatric patients (Cantwell, 2020). For instance, patient-centered health interventions allow positive experiences by involving patients’ in their treatment. The care providers can ensure the following interventions such as 

  • Informing mental health patients of different treatment methods and options. 
  • Involving patients of depression and anxiety in decision-making. 
  • The patients are informed of any alterations made in the coordinated care plan beforehand. 

This shows that nurses can help patients to get a clear understanding of their mental health treatment and involve them in a two-way communication with their providers. Moreover, giving patients a voice in care planning is also an ideal strategy to improve their mental health outcomes. 

Ethical Decisions in Designing Patient Centered Healthcare Interventions 

NURS FPX 4050 Assessment 4 Final Care Coordination Plan TS

The evidence from the research conducted by  Epstein (2017) shows that the primary goal of a hospital or a nursing home is to secure a good quality of life for patients. However, for patients suffering from severe and chronic mental illnesses, tying goals can become a challenge. Moreover, a culture-focus debate can be done on the matter of improving the satisfaction and life-quality of mentally ill patients using patient-centered interventions. Ethical principles are the intrinsic factors of patient-centred medical care. For instance, the study by Forsythe (2019) states that Amyotrophic lateral sclerosis (ALS) is the fiercest neurological conditions in which patties lose their abilities to speak and walk. Patients suffering from this disease can die within three years after having a paralysed mind or body.  Since a patient-centered approach is the most respectful approach that meets the demands and preferences of patients, ethical decision-making often results in patients’ empowerment by giving them a chance to participate in decision-making process (Goldfarb, 2017). The current literature provides ample evidence that a patient-centered approach should have an ethical foundation that should view a patient as an active part of the whole treatment process. The research by Jollies (2019) explored PCC outcomes within nursing settings by considering patients’ as a focal point of medical settings. This shows that Vila Health Hospital must also adopt the same patient-centered approach that finds its roots in Aristotle’s Principles of human flourishing where quality becomes a habit rather than an act. This can imply that Vila Health Hospital must treat each mental health patient as a special entity or a case that should be solved on an individual basis. Therefore, nurses and doctors in our facility should listen to the patients and consider their experiences valuable to match their treatment expectations. Moreover, another ethical principle that should be implemented in Vila Health Hospital is improving patients’ integration with the environment and understanding patients’ narrative with dialogue and interaction (Kao, 2021). Hence, ethical decisions such as considering patients’ individual expectations and sharing experiences can lead to improved healthcare outcomes for mentally ill patients in the hospital. 

Policy implications for the coordination and continuum of care

The adoption of patient-cantered policies can enhance the delivery of mental health treatment in Vila Health Hospital. The evidence by  Kuo, (2018) states that the role of health information technology in implementing the vital components of patient-cantered approach in several healthcare facilities. The researchers suggest that mental health priorities for depression and anxiety patients must be a priority for patient-cantered nurses and psychotherapists. They should use evidence-based strategies to treat patients in their primary care settings consistently with patient-cantered components. For that, a policy is needed to ensure the viability of including mental health treatment into patient-cantered approaches. For example, some special patient populations such as children and cases of persistent mental illnesses need collaborative care. Patients with substance abuse and mental disorders should receive treatment in speciality settings which should perceive adequate treatment of their health problems. However, some researchers such as McAllister (2018) argue that a typical healthcare organization faces difficulties in offering the highest quality mental health treatments. Many PCPs report that they lack training in the diagnosis and treatment of mental disorders (Naught on, 2018). This means there is a need for education and training to provide the best advice to patients. However, Vila  Heath hospital can use vital policy options to improve the capacity of patient-cantered to better serve the needs of mentally sick patients. For example, the research by Pinto (2020) suggests that leadership is required at all levels of providing patient-cantered interventions. Substantial training of nurses will be essentially important to dares the issues raised by patients. 

Moreover, The Coca’s work includes gathering and analysing information to determine the local needs of people experiencing mental illnesses. The governing body in California is the State Government responsible for the regulation of healthcare facilities by involving many boards, committees, bureaus, and commissions (Prank, 2021). For example, a vital policy followed by Vila Health Hospital is facilitating mental health patients with limited English proficiency to ensure meaningful results. The language assistance requires nurses to speak several languages such as English and Spanish to provide a written translation where possible. Moreover, the implications of promoting education and respect for patients are positive because it helps people of every gender, sex, family status, disability, or religion to have equal access to all hospital facilities and resources.  

According to Thombs (2020), the US healthcare system is changing rapidly. The coordinated care plan has the potential to improve safety and effectiveness of Vila Health Hospital. For example, in the past five years, the hospital’s management observed that the cost or price of not following a patient-centered policy for coordinated care has created a $25,000 waste with unnecessary hospital admissions. This shows that the care coordination policy helps nursing professionals and doctors to work at the top of their credentials and engage patients in their own care to achieve better outcomes. Moreover, the policy also has implications such as creating a consensus among healthcare professionals to follow the standard model for continuum of care. Such policies have helped hospitals to save more money and achieve better results in terms of sharing information and achieving healthcare outcomes. 

Care coordinator Priorities to Discuss the Plan 

According to Van Spall  (2019), a better care coordination plan can help nurses to identify several ways to engage in more resilient communication with patients and their families. For instance nurses can use some basic to advanced communication skills to enhance relationships and provide follow-up to patients’ responses. Many researchers emphasize creating strong communication bonds between nurses, patients, and their families. However, casual communication is not enough to know the patients effectively; nurses should use other ways to improve communication with patients’ families. This can be difficult for novice nurses to implement. They can ask questions from mental health patients such as ,”Do you have children who go to school”? The bottom line is to help nurses set a priority for honest communication. Moreover, effective nurses are always positive and honest with patients’ families. If nurses do not know the answer to a question, they should not provide a wrong answer and should honestly admit their lack of knowledge. This can make patients trust a nurse related to their health information. Therefore, nurses should always prioritize their questions and should never ignore them to establish effective nurse-patient communication (Walton 2020). Another research discusses the importance of being genuine for nurses while communicating the care coordination plan with their patients. For instance,    (2017) discusses the importance of being genuine and not being an overly sarcastic individual which might negatively impact the nurse-patient trust and relationship in Vila Health Hospital. This implies that being authentic is the best approach nurses should follow in their relationships to help patients think they are devoted and authentic. Finally, nurses should also show that they deeply care about the patients by being polite and respectful. This means they should address patients with their first or last names depending on their seniority or social status. This involves making eye contact with patients as a method of proving that they care. All these priorities will empower nurses to discuss the care coordination plan more effectively with patients.

Compare Learning Session Content with Best Practices

NURS FPX 4050 Assessment 4 Final Care Coordination Plan TS

Another vital aspect of good patient centered coordination care is to align teaching sessions to the Healthy People 2030 document. Healthy People 2030 edition has been launched in 2020 that allows public health leaders to have a vital resource for improving their work. The document helps practitioners and nurses to enhance their own patient care outcomes to treat mental health patients well in Vila Health Hospital. Healthy People 2030 consists of new programs and strategies related to upload use disorder and several other issues. This means incorporation of Healthy People in learning session’s contents is going to be a great step to improve mental health disease prevention because it will surely provide a foundation for having benchmarks for nurses (Van Spall, 2019). For instance, research published by   Walton (2020) states that  Healthy People 2030 places a stronger emphasis on well-being and social determinants of health. This means that in Vila Health Hospital, nurses can follow these benchmarks to learn the best techniques to apply in their settings and ensure reduction of discrimination, poor mental health, and disparities. It helps nurses to track their hospital’s progress by identifying the needs of mentally ill patients. Using data and resources from Healthy People 2030, nurses will be able to enhance depression treatments in Vila Health Hospital settings during COVID-19 and identify metrics that matter the most leading to improvement and action (Thombs, 2020). 


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Brooks, H. L., Lovell, K., Bee, P., Sanders, C., & Rogers, A. (2018). Is it time to abandon care planning in mental health services? A qualitative study exploring the views of professionals, service users and carers. Health Expectations21(3), 597-605.

Cantwell, M., Walsh, D. M., Furlong, B., Moyna, N., McCaffrey, N., & Woods, C. (2020). The Development of the MedEx IMPACT Intervention: A Patient-Centered, Evidenced-Based and Theoretically-Informed Physical Activity Behavior Change Intervention for Individuals Living With and Beyond Cancer. Cancer Control27(3), 1073274820906124.

Epstein, R. M., Duberstein, P. R., Fenton, J. J., Fiscella, K., Hoerger, M., Tancredi, D. J., … & Kravitz, R. L. (2017). Effect of a patient-centered communication intervention on oncologist-patient communication, quality of life, and health care utilization in advanced cancer: the VOICE randomized clinical trial. JAMA oncology3(1), 92-100.

Forsythe, L. P., Carman, K. L., Szydlowski, V., Fayish, L., Davidson, L., Hickam, D. H., … & Anyanwu, C. U. (2019). Patient engagement in research: early findings from the Patient-Centered Outcomes Research Institute. Health Affairs38(3), 359-367.

Goldfarb, M. J., Bibas, L., Bartlett, V., Jones, H., & Khan, N. (2017). Outcomes of patient-and family-centered care interventions in the ICU: a systematic review and meta-analysis. Critical care medicine45(10), 1751-1761.

Jolles, M. P., Lengnick-Hall, R., & Mittman, B. S. (2019). Core functions and forms of complex health interventions: a patient-centered medical home illustration. Journal of general internal medicine34(6), 1032-1038.

Kao, L., Hui, K. K., & Hui, E. (2021). A Patient-Centered Integrative Approach Improves Visual Field Defect: A Case Report. Global Advances in Health and Medicine10, 21649561211021081.

Kuo, D. Z., McAllister, J. W., Rossignol, L., Turchi, R. M., & Stille, C. J. (2018). Care coordination for children with medical complexity: whose care is it, anyway?. Pediatrics141(Supplement 3), S224-S232.

McAllister, J. W., Keehn, R. M., Rodgers, R., & Lock, T. M. (2018). Care coordination using a shared plan of care approach: from model to practice. Journal of pediatric nursing43, 88-96.

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Pinto, R. M., & Park, S. (2020). COVID-19 pandemic disrupts HIV continuum of care and prevention: implications for research and practice concerning community-based organizations and frontline providers. AIDS and Behavior24(9), 2486-2489.

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NURS FPX 4050 Assessment 4 Final Care Coordination Plan TS

Thombs, B. D., Kwakkenbos, L., Henry, R. S., Carrier, M. E., Patten, S., Harb, S., … & Ellis, K. (2020). Changes in mental health symptoms from pre-COVID-19 to COVID-19 among participants with systemic sclerosis from four countries: a Scleroderma Patient-centered Intervention Network (SPIN) Cohort study. Journal of psychosomatic research139, 110262.

Van Spall, H. G., Lee, S. F., Xie, F., Oz, U. E., Perez, R., Mitoff, P. R., … & Connolly, S. J. (2019). Effect of patient-centered transitional care services on clinical outcomes in patients hospitalized for heart failure: the PACT-HF randomized clinical trial. Jama321(8), 753-761.

Walton, H., Spector, A., Williamson, M., Tombor, I., & Michie, S. (2020). Developing quality fidelity and engagement measures for complex health interventions. British journal of health psychology25(1), 39-60.

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