To prepare: Reflect on your Practicum Experiences in Weeks 4-7.Think about the evidence, concepts, and/or theories (evidence) learned throughout this program and your specialization.Analyze a problem,

Running head: PRACTICUM PROJECT PLAN (PPP) OVERVIEW 0

Practicum Project Plan (PPP) Overview

Dawna Meier

Walden University

The readmission at the hospital is a strong indicator for measuring the quality of care provided at the hospitals. The hospitals were charging a massive amount from the patients for re-admitting them at the healthcare to provide the required level of care to them. However, the introduction of the Hospital Readmissions Reduction Program as a part of the Patient Protection & Affordable Care Act 2012 compelled the hospitals to reduce their cutbacks while giving re-admission to the patients at the hospitals (Learner, 2017). The 2020 budget introduced by the Trump government also compelled the hospitals for bringing a massive reduction in their readmission costs providing a great opportunity to the patients for visiting the healthcare to receive appropriate healthcare (Pramuk, 2019). Now, it is essential to mention that various home and community care programs are operating in the USA working to deliver healthcare services to the patients at their homes. There are various government programs like HACC i.e. Home and Care Community working with the same objective (Reeves, Schairer, & Jevsevar, 2018). It is significant to evaluate the effectiveness of the same programs after the hospitals' readmission fees cost reduction.

The goal of the project is to measure the impact of cost reduction in patient readmissions at the hospitals over the home care community.

The objectives of the study to achieve the goal are as follow:

• To measure the rise in the readmissions of the patients at the hospitals

• To analyze the benefits experienced by the patients after readmission fee cost reduction at the hospitals

• To identify the decline in the usage of home care community services by the patients

• To highlight the impact being created over the home care community after patient readmission cost reduction at the hospitals

The readmission fees at the hospitals in the USA were extensively high creating certain troubles for the patients. The hospitals were reaching to the amount of about $ 41.3 billion in a year from the patients readmitted at the hospital discharged in the last 30 days (Reeves, Schairer, & Jevsevar, 2018). This kind of high charging from the patients was creating certain implications for the patients as they were had to bear high financial hurdles for gaining due care from the hospitals. Due to the same reason, the government introduced various home and community care programs for the benefit of the patients in the community (Learner, 2017). These programs were designed for providing appropriate healthcare to the patients within their home environment. The patients receiving such treatment at the homes were less likely to get readmission at the hospitals with an annual figure around 23.7% as compared to the 33% of the in-patient cohort (Reeves, Schairer, & Jevsevar, 2018). Moreover, the patients were also saving a marginal amount by avoiding their readmission visits to the hospitals (Kirkland, Barfield, Demos, Pellegrini, & Drew, 2019).

With the introduction of the Hospital Readmissions Reduction Program as a part of the Patient Protection & Affordable Care Act 2012, things started to change for both the patients and the hospitals. The government policies compelled the hospitals for reducing their readmission fees up to maximum extent creating financial implications for them (Thabethe, 2010). The patients also started preferring the hospitals as compared to the health and community care providers considering the similar pricing of both the stakeholders; therefore, the readmission rate at the hospitals jumped massively by 37% creating implications for the home and community care programs (Learner, 2017). The budget is allocated for such programs are serving a limited purpose at the current time as the interest of the patients is shifting towards readmission at the hospitals (Konetzka, Karon & Potter, 2012). The government can shut down such programs witnessing the changing social behavior of the patients towards the hospitals depriving the other ones too from the same facility.

The research will be making use of quantitative research design for meeting the objectives of the study. The rationale behind the selection of quantitative research design for the study is that it will deliver objective and accurate results that could be summarized for supporting the generalizations regarding the aspect of the study (Kennedy-Clark, 2015). Moreover, the research design will eliminate the factor of biases up to a maximum extent. The research will be making use of the survey method for collecting the desired data from the subject. The researcher will be able to conduct the same method of online gaining cost and time benefit (Griga, 2017). The researcher will be making use of systematic sampling for the research to gather data from the population. There will be two populations in the study amongst which random sampling will be carried out including patients and home care health community (Kennedy-Clark, 2015). The data gathered from the patients will benefit the researcher in meeting its first and second objectives, where the data gathered from the home care health community will benefit the research in achieving its third and fourth objectives.

The researcher will be requiring various tools for completing the research work including a computer, ICT tools, SPSS, university library account, internet, and Survey Monkey. The researcher will be making use of the university library account for accessing authentic resources to carry out a sufficient literature review for grabbing the basics of the subject (Kennedy-Clark, 2015). The survey monkey and SPSS will benefit from collecting and analyzing the data gathered from the population. The computer and ICT tools will support in completing the above tasks along with the preparation of the final report (Griga, 2017).

The researcher will be carrying out a formative evaluation of the paper at regular intervals during the pace of the study. The researcher will be sharing the progress of the paper after completion of every milestone with the research supervisor and peers. The researcher will request both entities to provide feedback over the work completed up till yet (Sridharan, Tai, & Boud, 2018). The peers will benefit the researcher in identifying any weak area existing in the research work completed up till yet which could be improved. The research supervisor will be evaluating the concept of grip over the research work being completed. The research supervisor will also identify the areas that could be improved within the research work to deliver a masterpiece (Dolin, Black, Harlen & Tiberghien, 2017). The researcher will be making use of feedback achieved from both the research supervisor and peers to bring necessary changes in the context of research work and direction as per the nature and severity of the feedback.

After completion of the research work in a complete manner, the researcher will be submitting the complete draft of the research work to the research supervisor for final evaluation. The research supervisor will be supporting the researcher in identifying the flaws existing in the report and areas for improvement (Sridharan, Tai, & Boud, 2018). The researcher will make use of those feedbacks for bringing necessary modifications in the research work to deliver a final copy beneficial for the targeted stakeholders relevant to the nature of the research work.

References

Dolin, J., Black, P., Harlen, W., & Tiberghien, A. (2017). Exploring Relations Between Formative and Summative Assessment. Contributions from Science Education Research Transforming Assessment, 53–80. doi: 10.1007/978-3-319-63248-3_3

Griga, W. (2017). Quantitative Research Design and Methodology. Managing Inpatriation, 73–91. doi: 10.1007/978-3-658-18829-0_5

Kennedy-Clark, S. (2015). Reflection: Research by design: Design-based research and the higher degree research student. Journal of Learning Design, 8(3). doi: 10.5204/jld.v8i3.257

Kirkland, P. A., Barfield, W. R., Demos, H. A., Pellegrini, V. D., & Drew, J. M. (2019). Optimal Length of Stay Following Total Joint Arthroplasty to Reduce Readmission Rates. The Journal of Arthroplasty. doi: 10.1016/j.arth.2019.08.059

Konetzka, R. T., Karon, S. L., & Potter, D. (2012). Users Of Medicaid Home And Community-Based Services Are Especially Vulnerable To Costly Avoidable Hospital Admissions. Health Affairs, 31(6), 1167–1175. doi: 10.1377/hlthaff.2011.0902

Learner, S. (2017). Cost-cutting to remove home care as an option in some CCGs. Nursing and Residential Care, 19(3), 126–126. doi: 10.12968/nrec.2017.19.3.126

Pramuk, J. (2019, March 12). Trump pledged to protect Medicare and Medicaid, but his 2020 budget calls for major spending cuts. Retrieved from https://www.cnbc.com/2019/03/12/trump-2020-budget-proposes-reduced-medicare-and-medicaid-spending.html.

Reeves, R. A., Schairer, W. W., & Jevsevar, D. S. (2018). Costs and Risk Factors for Hospital Readmission After Periprosthetic Knee Fractures in the United States. The Journal of Arthroplasty, 33(2). doi: 10.1016/j.arth.2017.09.024

Sridharan, B., Tai, J., & Boud, D. (2018). Does the use of summative peer assessment in collaborative group work inhibit good judgement? Higher Education, 77(5), 853–870. doi: 10.1007/s10734-018-0305-7

Thabethe, N. (2010). Community home-based care – a cost-effective model of care: who benefits? AIDS Care, 23(7), 787–791. doi: 10.1080/09540121.2010.487086