Assessment 6: Final Project Submission

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Student Name

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Capella University

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Course Name

Prof Name
PX March 15 , 2024
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Abstract
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This final project aims to improve patient understanding after discharge, reduce hospital
readmissions, and enhance patient satisfaction following cardiac catheterization by
implementing a tailored educational program and integrating telehealth services. Addressing a
gap in knowledge and care continuity for post-cardiac catheterization patients, the initiative
offers personalized discharge education and utilizes various educational methods. Key findings
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highlight the crucial role of nurses in facilitating knowledge transfer and the connection between
well-informed patients and decreased readmission rates, suggesting potential cost savings for
healthcare facilities.

Introduction
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This capstone project addresses the elevated 30-day hospital readmission rates among
Coronary Artery Disease (CAD) patients discharged post-cardiac catheterization at Manatee
Memorial Hospital in Bradenton, Florida. The focus is on refining post-discharge patient
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education to achieve better outcomes. The intervention blueprint includes comprehensive and
individualized discharge education, incorporating tailored educational programs and telehealth
services. Execution involves transformative leadership, precise goal delineation,
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patient-centered care, and adherence to regulatory guidelines, with a target timeline of 12 to 18

months.

Problem Statement
Need Statement

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The project aims to compare the impact of a comprehensive, personalized post-discharge
education program against basic discharge instructions on 30-day hospital readmission rates
and patient outcomes for CAD patients discharged from Manatee Memorial Hospital
post-cardiac catheterization.

Population and Setting

The target population comprises post-cardiac catheterization patients at Manatee Memorial
Hospital, who face an increased risk of complications post-discharge. The tailored approach
aims to enhance patient satisfaction and reduce readmission rates in this setting.

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Intervention Overview
Two interventions are proposed: tailored discharge education and telehealth services. The
Plan-Do-Check-Act (PDCA) cycle guides the development of an individualized post-cardiac
catheterization education program. Inter-professional collaboration and alternative approaches,

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such as standardized education plans or group sessions, are being considered.

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Initial Outcome Draft
The objective is to decrease 30-day readmission rates by 20%, increase medication adherence
by 15%, boost follow-up appointment attendance by 30%, and encourage symptom reporting by
25%.
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Time Estimate
The estimated timeframe for program development and implementation is approximately 12
months, covering planning, platform development, pilot testing, and full-scale implementation.
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Literature Review
Existing literature supports the efficacy of comprehensive education for post-cardiac
catheterization patients, emphasizing personalized interventions and the importance of
telehealth in continuous support and reduced readmission rates.
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Interventional Plan
Intervention Plan Components
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The plan includes tailored educational programs and telehealth services. Customized
educational plans involve patient assessments, profiling, and personalized discharge
instructions. Telehealth services utilize audiovisual and remote monitoring devices for
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post-discharge education and monitoring.

Cultural Needs and Characteristics

Given the diverse population in Bradenton, Florida, the intervention prioritizes cultural
competence, respecting language preferences, cultural beliefs, and health practices. Tailored
communication strategies aim to effectively engage patients.

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Theoretical Foundations
Dorothea Orem's Self-Care Theory guides the intervention plan, emphasizing patient
engagement in self-management. Motivational interviewing addresses patients' readiness for
change, while telehealth services align with Orem's theory, supported by literature indicating
positive outcomes.

Conclusion
The project aims to bridge the knowledge gap in post-cardiac catheterization care, emphasizing
personalized education and telehealth services. The theoretical foundation and literature review
support the comprehensive intervention plan, tailored to the cultural needs of Bradenton,

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Florida's diverse population.

Stakeholders, Policy, and Regulations

Patients and their caregivers are central stakeholders in our intervention strategy for

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comprehensive discharge education. Meeting patient needs is crucial for enhancing
engagement, satisfaction, and adherence to care plans, resulting in desired outcomes such as

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reduced readmission rates and improved health results. Healthcare professionals support our
educational intervention through collaboration and care coordination. Administrators, managers,
and IT professionals play vital roles in managing human, financial, and technological resources,
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aiding in resource allocation, budget management, and technological support throughout the
planning and implementation phases.

External stakeholders, including insurance providers and regulatory bodies, play essential roles
in providing reimbursements and maintaining legal and ethical standards. Healthcare
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regulations such as Medicare’s Hospital Readmission Reduction Program (HRRP) and the
Health Insurance Portability and Accountability Act (HIPAA) are relevant to our intervention plan.
The HRRP penalizes hospitals with higher-than-expected readmission rates for chronic health
conditions, focusing on comprehensive discharge planning to reduce readmission rates.
Similarly, our program's policy emphasizes comprehensive discharge education to achieve
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reduced readmission rates, enhanced patient education, improved outcomes, and heightened
healthcare quality.
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The HIPAA Act, which underscores the protection of patients’ privacy during telehealth
interactions, is especially pertinent to our plan, which involves using digital resources and
educational virtual platforms. Safeguarding patient information's security and confidentiality is
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fundamental to complying with HIPAA guidelines. This analysis assumes that stakeholders and
regulations directly impact the plan’s successful implementation, emphasizing the need for
adequate support, funding, and collaboration from internal and external stakeholders.
Regulatory compliance is essential to maintaining ethical and legal care standards for patient
satisfaction.

Existing and New Policies

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Existing reimbursement policies can ensure healthcare workers receive compensation for
telehealth services. If such policies are not available in a state, they can be developed to
incentivize providers to offer telehealth services, ultimately increasing healthcare accessibility
for patients. Standardizing digital health educational materials is equally important to ensure
accurate and reliable information is disseminated to patients. Policies promoting collaborative
care, interdisciplinary teamwork, and the involvement of various healthcare disciplines in patient
education and care planning could be established. Policies like the Affordable Care Act (ACA)
can target health disparities within a state, providing funding and resources to underserved
communities for access to telehealth services and digital educational resources.

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Timeline
The proposed timeline for implementing our comprehensive discharge education plan’s
two-pronged approach, involving customized education plans and telehealth services, depends
on factors such as patient-specific needs, resource availability, stakeholder commitment,

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patients’ readiness for change, and technological infrastructure availability. However, a
reasonable implementation timeframe is set at 12-18 months, considering the time-consuming

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processes
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