Essay On Generating Consensus With The Stakeholders

Implementing a Case Management Protocol

Introduction
The implementing of case management protocols in the community requires the use of appropriate approaches and models. This is because it is necessary to gain consensus from the relevant stakeholders so that such case management protocols are not only successful, but also sustainable over time. This paper delves in the implementation of a case management plan in the community. Besides the implementation plan, the paper will also highlight the approach to generate consensus among the relevant stakeholders and the planned outcomes of the case management protocol.

Implementation of the Case Management Protocol in the Community

Various models have been designed for the implementation of case management protocols. The preference for any of these models is informed by the inherent benefits in the different models. The most fitting model for the execution of this case management protocol is the population-based care management model (Finkelman, 2011). The rationale for this model is that populations in need of care must receive the care in consideration of perspective of their health status and the relationship between the existing conditions and the risk for conditions (Finkelman, 2011).
Using the population-based care management model, the implementation of the case management protocol will be classified into three broad classes of patients. The three classes include the well patients, the at-risk patients and the unstable patients (Finkelman, 2011). The implementation of the case management plan in the community will focus on the at-risk patients. The implementation of the case management protocol will ease the movement of people from the at-risk group into the well group and out of the unstable group into the two other groups (Finkelman, 2011).
Besides this classification, the implementation will involved a eleven step process that will culminate in the evaluation of the case management protocol in order to determine the achievement of the outlined outcomes. The initial step of the execution plan will involve a scoping exercise where the number of patients in the community who fall under the at-risk classification will be determined. This is important for the planning of among other aspects, the number of case managers and the other resources required for the implementation of the case management protocol (Northern Ireland Department of Health, Social Services and Public Safety, 2008).
The second step of the implementation has been preempted by this write up as it involves generating consensus on the appropriate model for the implementation of the case management protocol. The third step will involve modeling the health care staff within the community. This entails the development of a workforce strategy, a workforce plan, modalities of recruitment and retention, workforce expansion plan and learning and development protocols. The fourth step of the implementation process involves standardizing the core elements of the case management protocols. The core elements include case finding, assessment, personalized care plans, interventions and continual review (Northern Ireland Department of Health, Social Services and Public Safety, 2008).
The fifth step involves outlining the structures of the services encompassed in the case management plan. The sixth step involves defining the core functions and roles of the health care staff, specifically the case managers and case finders. The seventh step of the process involves changing the role that the patient plays in case management. This involves capacity building the patient and their families to enable them manage the disease conditions from the home setting. This will include training on self management, encouraging user-led programs at self management and the dissemination of information regarding self management (Northern Ireland Department of Health, Social Services and Public Safety, 2008).
The eight step of the implementation process entails the development of supporting roles. Various agencies in the health care system are required to provide support for the case management protocol. The development of an overarching framework is important for the implementation of the protocol. Some of the agencies in the health care system whose support is required for the successful implementation of the case management protocol include pharmacy support, general practitioner services, information support, statutory and voluntary agencies and other existing services in the community (Northern Ireland Department of Health, Social Services and Public Safety, 2008).
The ninth step in the implementation process involves supporting the changes resulting from the case management plan. This involves cultivating culture shifts within the health and social care so as to enhance the sustainability of the case management plans. Of particular importance to this endeavor are striking collaborative partnerships between different organizations operating within the community. The tenth step of the implementation involves monitoring the progress and evaluating the achievement of the planned outcomes (Northern Ireland Department of Health, Social Services and Public Safety, 2008).
The monitoring and evaluation can be done at different states in the life of the case management protocol. The final step involves a cost benefit analysis for the implementation exercise. One of the key tenets of case management is the reduction in cost (Finkelman, 2011). It would be an important lesson for this project and subsequent projects of the same and different nature to determine the cost effectiveness on the case management protocol.

Getting key stakeholders to buy into a project is very imperative to the achievement of oucomes of the program. By getting the key stakeholders to buy into the project not only enhances the success of the project in the short term, but also sustainability in the long term. An effective approach is required to get the key stakeholders to buy into project. The approach used in this program is involving the stakeholders throughout all the phases of the project. Their involvement in the project will enable them to own it, thereby offering their unwavering support with time, resources and expertise (Townley & Yalowich, 2013). The involvement will be initiated from the initial stages of the implementation phase (Preskill & Jones, 2009). This will enable the implementation committee to determine and meet the needs of the key stakeholders before the implementation phase progresses to the later stages.

Key Outcomes

As highlighted earlier, the final two steps of the implementation phase include monitoring and evaluation and cost benefit analysis. It is in these two phases where the planed outcomes of the case management plan are evaluated. Some of the key outcomes that will be considered during the evaluation phase include a reduction on the overall length hospitalization for the patients involved. This is in line with the fact that one of the key functions of case management is the reduction in the hospitalization period (Finkelman, 2011).
Another key outcome of the project is a reduction in the number of emergency hospitalization. This is also in line with the function of case management of reducing exacerbations of chronic disease conditions. Other key indicators the size of case list for the case managers and a reduction in the number days.

Conclusion

The implementation phase of this project is important for its success. The implementation of the project uses a population-based care model where the patients are classified into three groups; the well group, the at-risk group and the unstable group. Under this classification, the implementation of the project will focus on the at-risk group in order to fast track the movement of cases in and out of one group to another. This will be done in eleven steps that run through the life of the project. Throughout this process, the key stakeholders in the community will be involved in order to achieve sustainability.

References

Finkelman, A. (2011). Case management for nurses. Upper Saddle River. Pearson Education Inc.
Northern Ireland Department of Health, Social Services and Public Safety. (2008). A Model Framework for the Implementation of a Case Management Approach. Retrieved 3rd Jan 2015 from http://www.dhsspsni.gov.uk/a_model_framework_for_the_implementation_ of_a_case_management_approach_january_2008_v2.pdf
Preskill, H. & Jones, N. (2009). A practical guide for engaging stakeholders in developing evaluation questions. Retrieved 3rd Jan. 2015 from http://www.rwjf.org/content/dam/ web-assets/2009/01/a-practical-guide-for-engaging-stakeholders-in-developing-evalua
Townley, C. & Yalowich, R. (2013). Five Key Strategies to Engage Health Care Payers and Purchasers in a Multi-Payer Medical Home Initiative. Retrieved 3rd Jan. 2015 from http://www.nashp.org/sites/default/files/pcmh.payer_.purchaser.engagement.pdf