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Benchmark – Evidence-Based Practice Proposal Paper

Benchmark – Evidence-Based Practice Proposal PaperBenchmark – Evidence-Based Practice Proposal PaperHCA-699- Evidence Based Research ProjectAssessment DescriptionThroughout this course, you have been developing a formal, evidence-based practice proposal.The proposal is the plan for an evidence-based practice project designed to address a problem, issue, or concern with Care Management. Although several types of evidence can be used to support a proposed solution, a sufficient and compelling base of support from valid research studies is required as the major component of that evidence. Proposals are submitted in a format suitable for obtaining formal approval in the work setting. Proposals will vary in length depending upon the problem or issue addressed, but they should be at least 3,500 words. The cover sheet, abstract, References page, and appendices are not included in the word count.Section headings and letters for each section component are required. Responses are addressed in narrative form in relation to that number. Evaluation of the proposal in all sections is based upon the extent to which the depth of content reflects graduate-level critical thinking skills.Benchmark – Evidence-Based Practice Proposal PaperThis project contains six formal sections: Please use the attached sections A-F which has already been written and include it in the final paperORDER A PLAGIARISM-FREE PAPER HERE1. Section A: Problem Description2. Section B: Research Support3. Section C: Proposed Solution4. Section D: Change Model5. Section E: Implementation Plan6. Section F: Evaluation of ProcessThe final paper will consist of the completed project, title page, abstract, References list, and appendices. Appendices will include a conceptual model for the project, handouts, data and evaluation collection tools, a budget, a timeline, resource lists, and approval forms.An abstract is required for the final paper.Refer to the “EBP Implementation Plan Guide” and the “Evidence-Based Practice Project Proposal Format” as tools for developing your proposal.Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.Benchmark – Evidence-Based Practice Proposal PaperCare Management Grand Canyon UniversityHCA-699- Evidence Based Research ProjectCare ManagementCare management is a term that refers to the activities carried out to improve patient care and reduce the need for medical services by enhancing care coordination and helping patients and caregivers to manage their healthcare conditions effectively. Care management utilizes several integrated programs which extend beyond current clinical care. Care management consists of several healthcare professionals, such as nurses, social workers, and patent educators. These healthcare management professionals work collaboratively to create a health care plan that will help meet the specific needs. Care management services include patient education, medication management, managing symptoms, and preventative testing. This essay aims to formulate a PICOT question associated with care management, describing the problem’s background and identifying the key stakeholders.Benchmark – Evidence-Based Practice Proposal PaperBackground of the ProblemThe problem that is aimed to be solved in care management is high rehospitalization rates due to poor care management among adults. Older adults are at risk have several complex medical and social needs that are fatal and can result in high increased mortality rates among older adults if care management for these adults is not efficient and effective. These medical conditions and social needs result in rapid hospitalization of older adults, which can be prevented through care management ((Wideman, 2012). Although the united states government has put in place several regulations and policies to ensure that the care management offered to older people is the best, several challenges have made it impossible to meet goals that have been put in place. One of the challenges includes a lack of guidelines to address care transitions between the hospital and the nursing home. Standardized disease management approaches should be introduced in geriatric care management to help lower hospitalization rates of the intended population. One of the ways to improve the quality of geriatric care management is through the use of pay for performance incentives. Pay for performance incentives are offered to healthcare providers if they meet specific performance results instead of their work. This incentive will motivate the healthcare team responsible for geriatric care management to improve the quality of care, efficiency, and the overall care they will be providing for the older adults, resulting in reduced hospitalization rates.Benchmark – Evidence-Based Practice Proposal PaperStakeholdersSeveral stakeholders are involved in the care management of older persons. These stakeholders are older adults, healthcare providers, the united states government, payers and policymakers, and the Medicare and Medicaid Services center. These stakeholders need to work together to ensure the successful implementation of the proposed solution. Implementing the proposed solution will help reduce the rehospitalization rates of older adults by improving care management which will benefit the older population.PICOT QuestionIn older patients (P), what is the effect of pay for performance incentives for nurses (I) on improving care management and reducing rehospitalization rates (O) compared with the use of social support (C) within six months?Purpose and Project ObjectiveThis project aims to improve the quality of geriatric care management, which will reduce rehospitalization rates among patients. The study’s objectives are: to improve the quality of geriatric care management within six months and reduce the rehospitalization rates of older adults within six months.Benchmark – Evidence-Based Practice Proposal PaperRationaleIt is important to address the issue of care management in older adults for several reasons. The first reason is that it will help reduce the mortality rates of older people, and the second reason is that it will help reduce rehospitalization rates (Vogeli et al., 2007). It is also important to address this issue to ensure quality and improved care for older adults.Initial Reference ListGolden, A. G., Tewary, S., Dang, S., & Roos, B. A. (2010). Care management’s challenges and opportunities to reduce the rapid rehospitalization of frail community-dwelling older adults. The Gerontologist, 50(4), 451-458.Donelan, K., Chang, Y., Berrett-Abebe, J., Spetz, J., Auerbach, D. I., Norman, L., & Buerhaus, P. I. (2019). Care management for older adults: The roles of nurses, social workers, and physicians. Health Affairs, 38(6), 941-949.Bodenheimer, T., & Berry-Millett, R. (2009). Care management of patients with complex health care needs. Policy, 1(6).Moyle, W., Olorenshaw, R., Wallis, M., & Borbasi, S. (2008). Best practice for the management of older people with dementia in the acute care setting: a review of the literature. International journal of older people nursing, 3(2), 121-130.Benchmark – Evidence-Based Practice Proposal Paper ReferencesVogeli, C., Shields, A. E., Lee, T. A., Gibson, T. B., Marder, W. D., Weiss, K. B., & Blumenthal, D. (2007). Multiple chronic conditions: prevalence, health consequences, and implications for quality, care management, and costs. Journal of general internal medicine, 22(3), 391-395.Wideman, M. (2012). Geriatric care management: role, need, and benefits. Home Healthcare Now, 30(9), 553-559.  AppendixHCA-699PICOT Question TemplateSection 1: In this section, provide one word to describe each section of your proposed PICOT question.Benchmark – Evidence-Based Practice Proposal PaperP   Population Older adultsI   Intervention Pay for performanceC   Comparison Social supportO   Outcome Improve care management and reduce rehospitalization ratesT   Timeline 6 monthsSection 2: Write your PICOT question below using the words listed above.PICOT   Section 3: Use your PICOT to develop a formalized statement. Use the examples below to help formulate the statement.In ___older patients____ (P), what is the effect of _pay for performance incentives for nurses______ (I) on __improving care management and reducing hospital reshoplizaton rates____(O) compared with _the use social support ______(C) within _six months_______ (T)? Are ____ (P) who have _______ (I) at ___ (Increased/decreased) risk for/of_______ (O) compared with ______ (P) with/without ______ (C) over _____ (T)? For ________ (P) does the use of ______ (I) reduce the future risk of _hospitalization _______ (O) compared with _________ (C)? Does __________ (I) influence ________ (O) in (subject) who have _______ (P) over ______ (T)?Benchmark – Evidence-Based Practice Proposal Paper PICOT TemplateCreswell, J. W. (2003). Research design: Qualitative, quantitative, and mixed methods approach. Sage Publications.Melnyk B., & Fineout-Overholt E. (2010). Evidence-based practice in nursing & healthcare. Lippincott Williams & WilkinsResearch SupportDescription of Search MethodA total of twelve research articles were selected for this assignment. These articles were obtained from Google Scholar, CINAHL, and the Cochrane Database. The keywords used to identify these articles are care management, social support, pay for performance incentives, and rehospitalization rates of older adults. The first inclusion criteria for the articles for the assignment were that they had to be recent within the past five years, and the articles also had to be peer-reviewed for them to be selected. The third inclusion criteria are that the articles must be relevant to the PICOT question to help inform the evidence-based practice. A total of forty-nine articles were first selected before being excluded based on the year published and relevance to the PICOT question. Thirty-seven articles did not meet the selection criteria and were excluded from the study, and twelve articles met the selection criteria.Benchmark – Evidence-Based Practice Proposal PaperSummary of Research StudiesDonelan et al. (2019) conducted a qualitative study to determine how healthcare practices allocate staff for care management activities. The data was collected through questionnaires, and 363 practices that offer geriatric care and 410 were studied. The study determined that when the practices had both registered nurses and a social worker, the role of physicians and NP clinicians differed when it came to chronic care management and care coordination activities. It also found out that registered nurses were more involved in care management and coordination during transitions. There were several limitations that the authors of the article identified. The first limitation is that the data was self-reported in a national random sample, resulting in sampling error and response or non-response errors (Donelan et al., 2019). The second limitation is that data on patient-centered medical home certification was not included in the questionnaires, or the sample frames used by the authors. The data obtained on care management is reliable for patients who are 65 years old or older and might not reflect on younger patients. The group of practices with social workers was small but not compared to registered nurses with the smallest representation. The strength of the study is that it has met its purpose and is relevant to my study.Bookey et al. (2017) conduct a systematic qualitative review of studies on how interprofessional collaborations impact care management in adults with chronic conditions. The authors determined that interprofessional collaborations are important to ensure proper care management of adults with chronic diseases. The study’s limitations are that the search timeframe limits the ability of the researcher to determine differences in how interprofessional collaborations can be used over time (Bookey et al., 2017). The second limitation is that the document was grouped based on the discipline of the first author while the other authors were from different disciplines, and the studies assessed chronic conditions based on a broad context vs. specific chronic conditions. The last limitation is that the selected studies are from developed countries, making it impossible to generalize findings to developing countries. The strength of this study is its validity and reliability.Benchmark – Evidence-Based Practice Proposal PaperHastings et al. (2021) conducted a qualitative study to determine the feasibility of video-enhancing care in the management of older veterans. The study determined that the use of video for the care management of older adults was rated higher for the participants familiar with the use of technology. Using videos for care management also improved engagement, communication, and interaction, improving the care management process (Hastings et al., 2021). The strength of the study is that it is reliable and valid. The limitations include evolving technology and its usage policies, small sample size, and the setting in a single healthcare system which reduces generalizability.Benchmark – Evidence-Based Practice Proposal PaperMendelson et al. (2017) carry out a systematic qualitative review of 69 articles that evaluate pay for performance programs. The purpose of the study by Mendelson et al. is to determine the effects of pay-for-performance programs in the healthcare delivery process and their impact on patient outcomes (Mendelson et al., 2017). The authors determined that pay for performance programs results in the improvement of the care process. The limitation of this study is that the study used few methodologically rigorous studies. The strengths of the study are that it is reliable valid, and it allows generalizability.The findings of Mendelson et al. are also supported by the article by Chen & Cheng, 2016. The quantitative study consisting of 114,295 participants aimed to assess the impacts of P4P programs for diabetes care on healthcare provisions and outcomes. The study determined that pay-for-performance programs increased the number of necessary examinations and tests and improved the continuity of care (Chen & Cheng, 2016). The study’s limitations include the lack of inclusion of certain characteristics in the PSM GEE models, lack of consensus on how MCCs can be defined, or measured and unique factors that limit the generalizability of the study’s findings. The strength of this study is that it is reliable and cost-effective.Benchmark – Evidence-Based Practice Proposal PaperHewner et al. (2016) conducted quantitative research, which consisted of 114 295 participants. The purpose of the study is to assess the relationship that exists between chronic disease complexity, health system integration, and the availability of care management interventions. The study determined lower rehospitalization rates for patients in managed care organizations and accountable care organizations. The research also found that transition care strategies improve continuity of care between two settings decreased rehospitalization rates (Hewner et al., 2016). The limitation of the study is that the counties that were studied have large urban areas with sizeable Medicaid populations where benefits vary from state to state, making it difficult to generalize the findings nationally. The second limitation is the changes in the United States healthcare environment due to the enactment of the affordable care act. The strengths of this study are its data collection methods and its reliability.McHugh et al. (2021) conducted a study to analyze the different approaches that aim to reduce readmission rates for the patients who have been discharged to skilled nursing facilities. The study determined that the provision of detailed discharge information and education of the skilled nursing facilities staff on care protocols resulted in a decline in hospital readmission rates. The limitations include the study setting where only two hospital systems in one city were assessed, affecting the generalizability of the research findings (McHugh et al., 2021). The other limitations include a limited number of qualitative interviews and differences in the baseline rehospitalization rates of the two hospital systems. The strengths include its validity, reliability, and its methodology.Benchmark – Evidence-Based Practice Proposal PaperTang et al. (2019) conduct a study to develop an internet of medical things-based geriatric care management systems. The authors determined that under the IoMT environment, the timesaving in executing total health monitoring improved the care management effectiveness and efficiency. The study also found out that the proposed system helped modify a care plan for older patients as their health status changed (Tang et al., 2019). The study’s limitations include the unwillingness of older adults to wear IoT devices, system blackouts, and the overreliance on domain experts’ knowledge. The strengths include generalizability, reliability, and validity.Benchmark – Evidence-Based Practice Proposal PaperZendehtalab et al., 2021 carry out a study on 11 different healthcare providers, with 54 older adults and 54 family members being the study participants. The study determined that the management of older adults can be improved by using the dynamic care model. The authors failed to identify the study’s limitations, and the strengths include reliability, generalizability, and validity.Kelly et al. (2017) carried out a systematic qualitative review consisting of 39 studies. The study determined that there was a relation between social relationships and the cognitive functioning of older adults. The limitation of the study includes challenges in identifying RCTs that include social relationships as interventions or active control components (Kelly et al., 2017). The strengths of the study are that it is reliable valid, and it allows generalizability.Smith et al. (2017) conduct a systematic quantitative review of 27 articles to assess the relationship between social support and physical activity. The study determined that social support made it likely for older persons to do LTPA (Smith et al., 2017). The limitations include the inclusion of studies and the variability of outcome measures. The strength of this study is its data collection methods and its reliability.Benchmark – Evidence-Based Practice Proposal PaperJu et al. (2017) conduct a quantitative study consisting of 535 289 participants. The study determined that pay for performance indicators results in a decrease in the length of stay in the hospital, a reduction in medical costs, and a decrease in the number of thirty-day readmissions (Ju et al., 2017). The study’s limitations include the inability to measure patient socioeconomic status and limitations in the data set.Description of the Validity of Internal and External ResearchInternal validity refers to the degree to which a study establishes trustworthy cause and effect relationships that are not influenced by other factors or variables. On the other hand, external validity is the degree to which results from studies can be applied in other situations. The reviewed studies have internal and external validity, which can help meet the study’s objectives.  Alignment to Measurable OutcomesThe objectives of the evidence-based practice are aligned to measurable outcomes, and this is because the increase or decrease of hospitalization rates can be measured. The improvement of care management can also be measured based on the health outcomes of this population.Benchmark – Evidence-Based Practice Proposal PaperAdjusted of PICOTI adjusted to PICOT based on the research that I carried out to ensure the objectives and goals of the study can be met in a timely and cost-effective manner. According to my instructor’s feedback, I also adjusted by incorporating and making changes in the instructor’s identified areas. ReferencesBookey‐Bassett, S., Markle‐Reid, M., Mckey, C. A., & Akhtar‐Danesh, N. (2017). Understanding interprofessional collaboration in the context of chronic disease management for older adults living in communities: a concept analysis. Journal of advanced nursing, 73(1), 71-84Chen, C. C., & Cheng, S. H. (2016). Does pay-for-performance benefit patients with multiple chronic conditions? Evidence from a universal coverage health care system. Health policy and planning, 31(1), 83-90.Donelan, K., Chang, Y., Berrett-Abebe, J., Spetz, J., Auerbach, D. I., Norman, L., & Buerhaus, P. I. (2019). Care management for older adults: The roles of nurses, social workers, and physicians. Health Affairs, 38(6), 941-949Hastings, S. N., Mahanna, E. P., Berkowitz, T. S., Smith, V. A., Choate, A. L., Hughes, J. M., … & Oddone, E. (2021). Video‐enhanced care management for medically complex older adults with cognitive impairment. Journal of the American Geriatrics Society, 69(1), 77-84.Benchmark – Evidence-Based Practice Proposal PaperHewner, S., Casucci, S., & Castner, J. (2016). The Roles of Chronic Disease Complexity, Health System Integration, and Care Management in Post‐Discharge Healthcare Utilization in a Low‐Income Population. Research in nursing & health, 39(4), 215-228.Ju Kim, S., Han, K. T., Kim, S. J., & Park, E. C. (2017). Pay-for-performance reduces healthcare spending and improves the quality of care: Analysis of target and non-target obstetrics and gynecology surgeries. International Journal for Quality in Health Care, 29(2), 222-227.Kelly, M. E., Duff, H., Kelly, S., Power, J. E. M., Brennan, S., Lawlor, B. A., & Loughrey, D. G. (2017). The impact of social activities, social networks, social support, and social relationships on the cognitive functioning of healthy older adults: a systematic review. Systematic reviews, 6(1), 1-18.Mendelson, A., Kondo, K., Damberg, C., Low, A., Motúapuaka, M., Freeman, M., … & Kansagara, D. (2017). The effects of pay-for-performance programs on health, health care use, and processes of care: a systematic review. Annals of internal medicine, 166(5), 341-353.McHugh, J. P., Shield, R. R., Gadbois, E. A., Winblad, U., Mor, V., & Tyler, D. A. (2021). Readmission reduction strategies for patients discharged to skilled nursing facilities: a case study from two hospital systems in one city—Journal of nursing care quality, 36(1), 91Smith, G. L., Banting, L., Eime, R., O’Sullivan, G., & Van Uffelen, J. G. (2017). The association between social support and physical activity in older adults: a systematic review. International Journal of Behavioral Nutrition and Physical Activity, 14(1), 1-21.Benchmark – Evidence-Based Practice Proposal PaperTang, V., Choy, K. L., Ho, G. T., Lam, H. Y., & Tsang, Y. P. (2019). An IoT-based geriatric care management system for achieving smart health in nursing homes. Industrial Management & Data Systems.Zendehtalab, H. R., Vanaki, Z., & Memarian, R. (2021). Improving the Quality of Geriatric Care for the Healthy Elderly in Comprehensive Health Centers in Iran. Iranian Journal of Ageing, 15(4), 428-439.HCA699-Evidence-Based Research ProjectHealth care is one of the critical aspects of our daily lives. It helps the patients to recover from their illness, thereby contributing to the sustainability of society (Peckham and Wallace, 2018). However, there is a gap in the daily management of hospitals, clinics, and other health care environments. Low quality of services from health care providers has diminished the rate at which patients, especially the older ones, recover from their illness. To improve the quality of service, the pay for performance is the ideal solution that can improve the morale and motivation among the health care providers (Brunn, 2017). The pay for performance arouses the interests of nurses since they feel a sense of belonging at their respective solutions. Additionally, it also increases coordination among the health care professionals that helps to improve the competency levels of the nurses and the doctors. In our health care setting, this solution might be realistic since the hospital management can reduce other unnecessary expenses and use the excess income to introduce the pay for performance initiative (Antoñanzas, Rodríguez-Ibeas, and Juárez-Castelló, 2018). However, cost leadership would be highly required in this case. The hospital management can reduce the number of suppliers and concentrate on the most critical aspect of the health care facility, such as drug availability. This would help them save excess funds for this initiative. In UK and Canada, this concept has gained popularity due to the effectiveness of the leaders (Mathes et al., 2019). The government and the leaders have co-operated to ensure health care professionals are paid according to their performance. In the last two years, both countries have recorded a 5% increase in the quality of services provided at health care facilities (Kovacs et al., 2020). Therefore, in our health care setting, it is possible to introduce this strategy to enhance the competency of health care services provided.Benchmark – Evidence-Based Practice Proposal PaperThe organizational culture is very crucial in a health care setting. It dictates the daily operations of any health care facility. The proposed solution is consistent with the operations of the organizational culture since it leads to improved performance in the health care facility. One of the objectives of the organizational culture is to set standards for improved performance through effective policies and laws (Peckham and Wallace, 2018). The policies and laws help to dictate the behavior and work ethics of employees. By introducing the pay for performance, the main objective would be to improve the quality of service, and hence, all the health care providers would be required to improve on their work standards to achieve this objective.Benchmark – Evidence-Based Practice Proposal PaperThe main stakeholders that the solution would impact are the nurses and the doctors. This is because they will be the main beneficiaries of this project, and their payment will be based on the quality of their performance. As Kovacs et al. (2020) note, an organization undertaking this initiative needs to ensure that the health care professionals are at the frontline of this project. Therefore, leaders need to hold a meeting with the nurses and doctors and inform them about the plan’s benefits and its relevance to the organization. This will help to improve the motivation and the morale of health care providers in this proposed solution.Numerous benefits would be expected from the project. First, health care providers and social caregivers would improve the quality of performance of the elders by providing both physical and social support. This would increase their lifespan (Antoñanzas, Rodríguez-Ibeas and Juárez-Castelló, 2018). The second goal lies in the intervention programs. The solution is expected to improve the level of competency among the health caregivers since they would improve their services and attract more patients to their health care environment. Another objective is to reduce the hospitalization rates of the elders by ensuring that they get all the medical attention that they would need (Brunn, 2017). Benchmark – Evidence-Based Practice Proposal PaperThe outcome for this solution would be achieved through the following.· The older adults would be given more attention that would improve their current situations. However, it is assumed that this would be possible if the nurses and social caregivers maintain consistency in their work.· The pay for performance initiative would improve the morale of the health care providers, which would help them improve on their intervention programs. However, this may only be possible if the initiative is free and fair to all the employees.Benchmark – Evidence-Based Practice Proposal Paper· Consistent checkups on older adults would ensure that they follow all the medical guidelines. Re-hospitalization rates will reduce if they do not suffer from serious health-threatening diseases that would require urgent medical attention.These changes would have an immediate impact on the quality care improvement of the patients. This is because the standards of medical services will improve, and the elders will also receive constant social care that would improve their conditions. ReferencesAntoñanzas, F., Rodríguez-Ibeas, R., & Juárez-Castelló, C. A. (2018). Personalizedmedicine andpay for performance: should pharmaceutical firms be fully penalized when treatment fails? Pharmacoeconomics, 36(7), 733-743.Brunn, M. (2017). Global ideas, national challenges: the introduction of diseasemanagement and pay-for-performance in France and Germany (Doctoral dissertation, Université Paris-Saclay). Benchmark – Evidence-Based Practice Proposal PaperKovacs, R. J., Powell-Jackson, T., Kristensen, S. R., Singh, N., & Borghi, J. (2020).How are pay-for-performance schemes in healthcare designed in low-and middle-income countries? Typology and systematic literature review. BMC health services research, 20(1), 1-14.Mathes, T., Pieper, D., Morche, J., Polus, S., Jaschinski, T., & Eikermann, M. (2019).Pay for performance for hospitals. Cochrane Database of Systematic Reviews, (7).Peckham, S., & Wallace, A. (2018). Pay-for-performance schemes in primary care:what have we learned? In The Quality and Outcomes Framework (pp. 137-146). CRC Press.HCA699- Evidence-Based Research ProjectBenchmark – Evidence-Based Practice Proposal Paper Part D – Change ModelRoger’s diffusion of innovation theoryImplementing pay for performance for nurses on improving care management and reducing re-hospitalization rates among the aging population can be done using Roger’s diffusion of innovation theory. Diffusion of Innovation (DOI) is used to explain how an idea gains momentum and spreads through a particular population over time. According to DOI theory, the spread’s result is that people adopt innovative ideas or behavior. Adoption means that there will be a meaningful change in the way people do things. In my organization, the implementation of pay for performance initiative will motivate nurses (García‐Avilés, 2020). It is also associated with low re-hospitalization rates among people with acute conditions, ensuring proper care management. The use of the DOI model to implement this initiative implies that after a short while, nurses and physicians who are the main stakeholders in the implementation of this initiative would start performing their roles differently than how they have been doing it previously.Benchmark – Evidence-Based Practice Proposal PaperThe adoption of an idea and innovation does not happen simultaneously in a healthcare organization. Instead, it is a process where some nurses and physicians are more apt to adopt the innovation than others. The model asserts that people who adopt an idea earlier have distinct features than those who embrace an idea later. There are five adopter categories proposed in DOI. They include innovators, early adopters, early majority, late majority, and laggards (Mohammadi et al., 2018). These adopter categories are used to appeal to the target population when promoting an innovation.Innovators: Innovators are a set of customers that use new products as soon as they are launched, that is are the first set of customers of any new technology or new products it count for 2.5% and product example of Innovation model is Foldable Phones, Foldable phones are very few in few in numbers and is a very new product, one will hardly find people using it. There is extraordinarily little that needs to be done to the initiative to appeal to these people.Early adopters: These are people who represent opinion leaders. These are people who embrace change opportunities in an organization and enjoy leadership roles. These people are aware that an organization needs change, and therefore they are comfortable adopting innovative ideas, and they do not need the information to convince them to change.Benchmark – Evidence-Based Practice Proposal PaperEarly Majority: These are the set of customers those who widely adopt an innovative new product and are accepted by the society as a products and people smart using it. Such products become constant for group of people and majority of people start using it. These counts for 34% example of such products are Debit cards and credit cards. Many customers nowadays use these cards for payments. These people need to see evidence to be convinced that the initiative works.Late majority: The late majority comprises a population of people who are skeptical about changing. These people will only adopt an idea after the majority has tried it. These people require information to be convinced of the effectiveness of the initiative.Laggards: Laggards consist of people who are bound with tradition, and they are also conservative. are the set of customers those who avoid using technology and stick to old technology and they use new products when they become old. These count for 16%. Product example is 2G internet service.This theory has been used successfully in many fields, including public health. Using this theory to implement the proposed change in my organization would ensure that the initiative is slowly and steadily adopted in the organization to enable it to gain momentum and become effective.Benchmark – Evidence-Based Practice Proposal PaperPart E – Implementation PlanThe implementation of any change requires a lot of finance used to buy equipment and tools for achieving the needs of the new initiative. The implementation process of pay for performance would require an increase in human capital as health professionals would be rewarded based on the quality of their work. The implementation of this reward system requires motivation from all health professionals. This would mean that all the nurses and physicians would require training and education to compete and achieve the needs of the new initiative. The implementation of the initiative will require a pay increase. This will need the organization to reduce supplies to concentrate on service delivery to obtain more funds for implementing the initiative.The feasibility of the implementation plan is concerned with the practicability of the initiative. The cost of purchasing computers for the implementation process is estimated at the cost of $200,000. The implementation of the initiative would require five computers that would be used to monitor the work of employees, record re-hospitalization rates, quality of care management per health professional, and the rates of chronic conditions reported in the organization. The organization will hire five professionals to facilitate the implementation of the initiative. These professionals would comprise an accountant, a health informaticist, and three IT experts. Each person will be paid $40,000 per month. These professionals will coordinate and manage the system. These professionals will do the activities such as data collection, analysis, storage, interpretations, and dissemination. Other costs incurred during the implementation of the initiative will include purchasing office equipment like tables, chairs and redesigning one room that will be used as the office for the implementors. The office equipment will cost $20,000, and the cost for restructuring and designing the new office will be $10,000.Benchmark – Evidence-Based Practice Proposal PaperThe potential barrier that will need to be assessed and eliminated during the initiative’s implementation is resistance to change. The pay for performance initiative is characterized by many disadvantages like affecting teamwork and leaving the possibility of subjectivity (Leite, Bateman & Radnor, 2020). Nurses and doctors who are the major stakeholders in this initiative may resist the implementation of the initiative. However, by informing the employees about the benefits of the initiative early and communicating how I plan to manage the problems, the problem will be eliminated.Benchmark – Evidence-Based Practice Proposal PaperThe implementation process of the proposed initiative will start on 1 January 2022 and is expected to end on 30 December 2022. The following steps will be followed: assessing the project plan, executing the plan, making changes as needed, analyzing project data, and gathering feedback, and providing a final report. ReferencesGarcía‐Avilés, J. A. (2020). Diffusion of innovation. The International Encyclopedia of Media Psychology, 1-8.Leite, H., Bateman, N., & Radnor, Z. (2020). Beyond the ostensible: an exploration of barriers to lean implementation and sustainability in healthcare. Production Planning & Control, 31(1), 1-18.Mohammadi, M. M., Poursaberi, R., & Salahshoor, M. R. (2018). Evaluating the adoption of evidence-based practice using Rogers’s diffusion of innovation theory: a model testing study. Health promotion perspectives, 8(1), 25.AppendixAppendix One: Roger’s diffusion of innovation theory   Appendix Two: Timeline for the Project ImplementationBenchmark – Evidence-Based Practice Proposal PaperDissemination of EvidenceCare Management Proposal IntroductionCare management is a term that refers to the activities carried out to improve patient care and reduce the need for medical servicesCare management consists of several healthcare professionals, such as nurses, social workers, and patent educators (Wideman, 2012).Care management services include patient education, medication management, managing symptoms, and preventative testingThe problem that is aimed to be solved in care management is high rehospitalization rates due to poor care management among adults.One of the ways to improve the quality of geriatric care management is through the use of pay for performance incentivesCare management is a term that refers to the activities carried out to improve patient care and reduce the need for medical services by enhancing care coordination and helping patients and caregivers to manage their healthcare conditions effectively. Care management utilizes several integrated programs which extend beyond current clinical care. Care management consists of several healthcare professionals, such as nurses, social workers, and patent educators. These healthcare management professionals work collaboratively to create a health care plan that will help meet the specific needs (Wideman, 2012). Care management services include patient education, medication management, managing symptoms, and preventative testing.2The PICOT QuestionIn older patients (P), what is the effect of pay for performance incentives for nurses (I) on improving care management and reducing rehospitalization rates (O) compared with the use of social support (C) within six months?Benchmark – Evidence-Based Practice Proposal PaperP-Elderly patientsI-Effect of pay performance incentives for nursesO-Improving care management and reducing rehospitalization ratesC-Compared with the use of social supportT-Within six monthsOne of the ways to improve the quality of geriatric care management is through the use of pay for performance incentives. Pay for performance incentives are offered to healthcare providers if they meet specific performance results instead of their work. This incentive will motivate the healthcare team responsible for geriatric care management to improve the quality of care, efficiency, and the overall care they will be providing for the older adults, resulting in reduced hospitalization rates.3The benefits of care managementHealth care providers and social caregivers would improve the quality of performance of the elders by providing both physical and social supportPay for performance is expected to improve the level of competency among the health caregivers since they would improve their services and attract more patients to their health care environmentPay for performance will reduce the hospitalization rates of the elders by ensuring that they get all the medical attention that they would needNumerous benefits would be expected from the project. First, health care providers and social caregivers would improve the quality of performance of the elders by providing both physical and social support. This would increase their lifespan (Antoñanzas, Rodríguez-Ibeas and Juárez-Castelló, 2018)Benchmark – Evidence-Based Practice Proposal Paper. The second goal lies in the intervention programs. The solution is expected to improve the level of competency among the health caregivers since they would improve their services and attract more patients to their health care environment. Another objective is to reduce the hospitalization rates of the elders by ensuring that they get all the medical attention that they would need (Brunn, 2017).4How the benefits will be achievedThe older adults would be given more attention that would improve their current situations.Benchmark – Evidence-Based Practice Proposal PaperThe pay for performance initiative would improve the morale of the health care providers, which would help them improve on their intervention programs.Consistent checkups on older adults would ensure that they follow all the medical guidelines (Peckham & Wallace, 2018)Re-hospitalization rates will reduce if adults do not suffer from serious health-threatening diseases that would require urgent medical attentionThese changes would have an immediate impact on the quality care improvement of the patients.The older adults would be given more attention that would improve their current situations. However, it is assumed that this would be possible if the nurses and social caregivers maintain consistency in their work.The pay for performance initiative would improve the morale of the health care providers, which would help them improve on their intervention programs. However, this may only be possible if the initiative is free and fair to all the employees.Consistent checkups on older adults would ensure that they follow all the medical guidelines. Re-hospitalization rates will reduce if they do not suffer from serious health-threatening diseases that would require urgent medical attention.These changes would have an immediate impact on the quality care improvement of the patients (Peckham & Wallace, 2018). This is because the standards of medical services will improve, and the elders will also receive constant social care that would improve their conditions.Benchmark – Evidence-Based Practice Proposal Paper5Implementation model for the initiative:Roger’s diffusion of innovation theoryDiffusion of Innovation (DOI) model is used to explain how an idea gains momentum and spreads through a particular population over time.The use of the DOI model to implement this initiative implies that after a short while, nurses and physicians who are the main stakeholders in the implementation of this initiative would start performing their roles differently than how they have been doing it previously (García‐Avilés, 2020).The model asserts that people who adopt an idea earlier have distinct features than those who embrace an idea later. There are five adopter categories proposed in DOI.They include innovators, early adopters, early majority, late majority, and laggardsImplementing pay for performance for nurses on improving care management and reducing re-hospitalization rates among the aging population can be done using Roger’s diffusion of innovation theory. Diffusion of Innovation (DOI) is used to explain how an idea gains momentum and spreads through a particular population over time. According to DOI theory, the spread’s result is that people adopt innovative ideas or behavior. Adoption means that there will be a meaningful change in the way people do things. In my organization, the implementation of pay for performance initiative will motivate nurses. It is also associated with low re-hospitalization rates among people with acute conditions, ensuring proper care management. Benchmark – Evidence-Based Practice Proposal Paper. The use of the DOI model to implement this initiative implies that after a short while, nurses and physicians who are the main stakeholders in the implementation of this initiative would start performing their roles differently than how they have been doing it previously. The adoption of an idea and innovation does not happen simultaneously in a healthcare organization. Instead, it is a process where some nurses and physicians are more apt to adopt the innovation than others. The model asserts that people who adopt an idea earlier have distinct features than those who embrace an idea later. There are five adopter categories proposed in DOI. They include innovators, early adopters, early majority, late majority, and laggards. These adopter categories are used to appeal to the target population when promoting an innovation.6Rodger’s diffusion of innovation theoryInnovators: Innovators are a set of customers that use new products as soon as they are launched, that is are the first set of customers of any new technology or new products it count for 2.5% and product example of Innovation model is Foldable Phones, Foldable phones are very few in few in numbers and is a very new product, one will hardly find people using it. There is extraordinarily little that needs to be done to the initiative to appeal to these people (García‐Avilés, 2020).Early adopters: These are people who represent opinion leaders. These are people who embrace change opportunities in an organization and enjoy leadership roles. These people are aware that an organization needs change, and therefore they are comfortable adopting innovative ideas, and they do not need the information to convince them to change.Benchmark – Evidence-Based Practice Proposal PaperEarly Majority: These are the set of customers those who widely adopt an innovative new product and are accepted by the society as a products and people smart using it. Such products become constant for group of people and majority of people start using it. These counts for 34% example of such products are Debit cards and credit cards. Many customers nowadays use these cards for payments. These people need to see evidence to be convinced that the initiative works.Benchmark – Evidence-Based Practice Proposal PaperLate majority: The late majority comprises a population of people who are skeptical about changing. These people will only adopt an idea after the majority has tried it. These people require information to be convinced of the effectiveness of the initiative.Laggards: Laggards consist of people who are bound with tradition, and they are also conservative. are the set of customers those who avoid using technology and stick to old technology and they use new products when they become old. These count for 16%. Product example is 2G internet service.7Timeline for the project implementationThe implementation process of the proposed initiative will start on 1 January 2022 and is expected to end on 30 December 2022. The following steps will be followed: assessing the project plan, executing the plan, making changes as needed, analyzing project data, and gathering feedback, and providing a final report.8Benchmark – Evidence-Based Practice Proposal PaperThe potential barriers to be eliminated during implementation processThe potential barrier that will need to be assessed and eliminated during the initiative’s implementation is resistance to changeThe pay for performance initiative is characterized by many disadvantages like affecting teamwork and leaving the possibility of subjectivityNurses and doctors who are the major stakeholders in this initiative may resist the implementation of the initiativeHowever, by informing the employees about the benefits of the initiative early and communicating how I plan to manage the problems, the problem will be eliminatedThe potential barrier that will need to be assessed and eliminated during the initiative’s implementation is resistance to change. The pay for performance initiative is characterized by many disadvantages like affecting teamwork and leaving the possibility of subjectivity (Leite, Bateman & Radnor, 2020). Nurses and doctors who are the major stakeholders in this initiative may resist the implementation of the initiative. However, by informing the employees about the benefits of the initiative early and communicating how I plan to manage the problems, the problem will be eliminated.9Implementation planThe implementation process of pay for performance would require an increase in human capital as health professionals would be rewarded based on the quality of their work.Benchmark – Evidence-Based Practice Proposal PaperThe implementation of the initiative will require a pay increaseThe cost of purchasing computers for the implementation process is estimated at the cost of $200,000.The organization will hire five professionals to facilitate the implementation of the initiative.The potential barrier that will need to be assessed and eliminated during the initiative’s implementation is resistance to changeThe implementation process of the proposed initiative will start on 1 January 2022 and is expected to end on 30 December 2022The implementation of any change requires a lot of finance used to buy equipment and tools for achieving the needs of the new initiative. The implementation process of pay for performance would require an increase in human capital as health professionals would be rewarded based on the quality of their work. The implementation of this reward system requires motivation from all health professionals (Peckham & Wallace, 2018). This would mean that all the nurses and physicians would require training and education to compete and achieve the needs of the new initiative. The implementation of the initiative will require a pay increase. This will need the organization to reduce supplies to concentrate on service delivery to obtain more funds for implementing the initiative.Benchmark – Evidence-Based Practice Proposal Paper10Project evaluationMethods of project evaluationReturn on investmentPayback methodPresent Net valueInternal rate returnThese are potential evaluation strategies that can be used to evaluate pay for performance initiativeROI is used as a criterion in an evaluation process (Witter et al., 2018). The higher the ROI, the higher is its acceptability. The concepts about the amount of investment in a project include the number of assets, capital investment, or equity capital. Return on asset is the ratio between net profit and the assets.Benchmark – Evidence-Based Practice Proposal PaperThe payback period is when the time between project implementation to the time when the profit becomes equal to the total costs of the projectTo understand how NPV works, we can assume that an initiative expects to obtain a revenue R1 in the initial year of project implementation and R2 in the second year, and R3 in the third year. Also, we can assume that the project’s initial cost is C1, and in addition, an organization will spend Q amount in the first year, C2 in the second year, C3, C4…Cn. From this illustration, we deduct the present value of the flow of costs of the project from the current value of the flow of revenue. The result from our calculations will be the NPV.11The appropriate evaluation methodNet Present Value (NPV)NPV has all the properties of project evaluationIt uses the rate of the opportunity cost of capital as the discount rate to find the present value of all the standard cots and profits.Benchmark – Evidence-Based Practice Proposal PaperIt also considers all the expected lows of losses and earnings of an initiative. Finally, it evaluates projects independentlyThe evaluation method that would be appropriate for my initiative is Present Net Value (NPV) (Witter et al., 2018). This is because NPV has all the properties of project evaluation. It uses the rate of the opportunity cost of capital as the discount rate to find the present value of all the standard cots and profits. It also considers all the expected lows of losses and earnings of an initiative. Finally, it evaluates projects independently.12ReferencesWideman, M. (2012). Geriatric care management: role, need, and benefits. Home Healthcare Now, 30(9), 553-559.Peckham, S., & Wallace, A. (2018). Pay-for-performance schemes in primary care:what have we learned? In The Quality and Outcomes Framework (pp. 137-146). CRC Press.Peckham, S., & Wallace, A. (2018). Pay-for-performance schemes in primary care:what have we learned? In The Quality and Outcomes Framework (pp. 137-146). CRC Press.García‐Avilés, J. A. (2020). Diffusion of innovation. The International Encyclopedia of Media Psychology, 1-8.Witter, S., Brikci, N., Harris, T., Williams, R., Keen, S., Mujica, A., … & Renner, A. (2018). The free healthcare initiative in Sierra Leone: evaluating a health system reform, 2010‐2015. The International journal of health planning and management, 33(2), 434-448.Benchmark – Evidence-Based Practice Proposal Paper 

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