Health Program Plan and Assessment

Project Definition

Chronic kidney disease is a condition that damages kidneys and reduces their ability to function. Chronic kidney disease causes waste build up in the blood resulting in high blood pressure and other implications. It is important to conduct the health program plan and assessment to determine the risk level in this area. This assessment will help determine the probability of individuals getting chronic kidney disease. It will also determine the elements at risk and estimate their economic value. The plan will determine the vulnerability of the elements at risk. This will help the government and other agencies to know how the population can be affected, in case of chronic kidney disease affects the community in this area (Walter, 2008).

The project is aimed at conducting a needs assessment the number of the people above the age of 65 years who suffer from chronic kidney disease. The project is aimed at reducing the number of the old people above the age of 65 years who suffer from chronic kidney diseases appreciably by 50%. The result of the project is expected to be felt within a period of eight months.

Project Name

The project name is “Reducing chronic kidney diseases at old age”.

Project Identification Tools

The project intends to use the following identification tools to gather reliable and valid evidence in order to identify the need for this quality development plan.

1. Interviewing the members who have infected family members, since they have been involved in the situation directly.
2. Observing the patients suffering from chronic kidney diseases, as this will give first hand information.
3. Brainstorming with the health professionals about the causes, effects and solutions to chronic kidney diseases because they are experienced in the field.
4. Focus group with health officers concerning the implementation of the project.
5. Reviewing the complaints regarding mental disorders.
6. Clinical indicators-old age chronic kidney diseases

Project Parameters

Problem: Benchmarking revealed higher incidence of chronic kidney diseases in older people in this region.

Boundaries: Patients below 65 years are also out of the boundary.

Importance of the Project

At old age, chronic kidney diseases have been proved to be common. However, these diseases are not frequently detected and, therefore, remain untreated. They induce disturbances, functional disability and rehabilitation, lower immunity and impair the quality of life of both the patients and their family members. The old require psychological services and rehabilitation to make their life comfortable.  According to the latest evidence, proper interventions and good policy implementation can appreciably reduce the risk of old age chronic kidney diseases (Mione, 2006). Recently collected data regarding old age chronic kidney diseases in this region, which was benchmarked, indicated high risk disorders to the old. This is where the assessment plan is to be implemented.

Project Goals

1. To assess the needs of the vulnerable group.
2. To assess the degree and nature of potential local participation in reducing the effects of chronic kidney diseases.
3. To assess the number of people already affected by chronic kidney diseases.
4. To identify time, duration and methods used for an individual to be diagnosed with chronic kidney diseases.

To reduce the incidence of chronic kidney diseases in the older people by 50%.

Project Scope

The ultimate result of the project will reduce old age chronic kidney diseases by 50% from baseline data. The project covers examination of baseline data at the start of the project and the continuous clinical indicator data collection throughout the duration of the project. Project data identification tools include interviews, observation, brainstorming, focus group and reviews. Teamwork will be utilized throughout the project and the team members educated appropriately. Members of the staff will also be trained on specific topics regarding old age disorders, data collection and successful organizational communication

Project Timeline

Project Length: 8 Months

Begin: December 2012

Completion: July 2013

Resources

The team will need finance to facilitate their undertaking and the implementation of the project. Various bodies will be responsible for all the resources used. They include; The Project Facilitators, Government, Ministry of Health and NGOs. Apart from the liquid cash, the team will also require the supply of the following:

• Back fill for team members to undertake the data collection and analysis; attend meetings;
• Participate in education
• Chronic kidney diseases products
• External education consultant
• Stationery and supplies
• Lunch and refreshments provided to staff attending meetings and education
• Computer, internet connection, microphone, camera
• Skype connection

Shortages in the budget such as capital inadequacy will be addressed.

Training Needs

The team will be trained in the following areas by mental professionals and other health consultants:

•  Data collection and analysis skills

•  Conflict resolution

•   Age related changes to the mental system

•   First aid

•   Prevention and management of old age chronic kidney diseases

•   Guidance and counseling

•    Working in teams

•    Effective team communication

•   Public relations

•   Disaster management

• Running successful meetings

Stakeholders:

• NSW Health

• Board of Directors of the organization

• Older people and their families

•  Patients with chronic kidney diseases

•  Counselors

•  Physicians

Team Selection

•  Coach/quality advisor: Quality Manager

•  Team leader: Quality Manager

•   Members of the team:

•   Counselor: To offer constant guidance and counseling to the patients and relatives.

•   Physician: To take care of patients’ medication.

•    Data collecting members: To go the field and collect data.

•    Older people, family members

The team will hold monthly meetings on every 15^th day of the month 10.00 AM -12.00 noon.

Operating Guidelines

The team will use the following methods of communication:

•  Minutes of meetings

•  Meeting agenda

•   Billboards

•  Memo

•  Posters of monthly old age mental disorders statistics

•  Face to face

•  Skype

•  Phone

•  Face book

•  Twitter

•  Email

• Brochures

In times of conflict the following methods will be applied to resolve them:

• Polling

•  Pros and Cons list

•  Causes and effects list

•   SWOT Analysis

• Majority rules

Resistance to change will be managed in the following ways:

•   Acknowledge people’s concerns and fears about change

•   Provide education on the change

•   Involve everyone in feedback about change

•  Engage everyone in the change process

•  Encourage everyone to be flexible and learn

• Facilitate feedback to all

The team will bring up issues in the following ways:

•  Contact the team leader who will add the issue to the meeting agenda

•  Raising AOB in the meeting

•  Suggestion box

•  Writing to the team leader

• Verbally to the team leader

Ground Rules of Behavior and Operation

•  No discrimination

•  Punctuality

•  Be time conscious

• Proper mode of dressing

• Etiquette

• Use of common language 

•  No bullying

•  Participate and support other team members

•  Be respectful

• Complete actions prior to the next meeting,

• Only one person at a time speaks during the meeting

•  Rules and regulations must be followed to the letter

Flow of Governance

Board of Governors

Director of Nursing

NUM

Team Leader

Team members

The team leader will report to the NUM Health who reports to the Director of Nursing if further resources are required. Team leader will have direct access to data, equipment, policies, rules and regulations, procedures and other relevant documentation. Team leader can request assistance from the Manager of Quality in head office whenever required.

Part II

Step I: Project Purpose Statement

By when: February 2013

Deliver what: Reduction by 50% in old age mental disorders rate in the unit

To whom: Director of Nursing

In order to assess the needs of patients of chronic kidney disease and evaluate ways of reducing chronic kidney disease, improve the quality of life for older people in the region and reduce length of admission, suffering and associated costs.

Step II: Goals

50% Reduction in old age chronic kidney disease rate incidence, decreased length of admission in hospital, reduce suffering considerably and decreased costs.

Step III: Data collection and Tools

Clinical indicators-chronic kidney disease

Interviewing family members using questionnaires and face to face interview

Staff focus group

Step IV: Data Collection Groups

Team members will collect all the required data in the field as follows:

Clinical indicators - monthly

Satisfaction survey - after every 3 months

Complaints review - monthly

Interviewing family members using questionnaires and face to face interviews - monthly

Focus group - at completion of project

Data will be collected on the region.

Step V: Brainstorm on the other tasks/deliverables required for the project

• Get sign off for project from NUM
• Finalize and review project plan
• Obtain baseline data
• Establish schedule for the project
• Establish and communicate meeting times and dates
• Arrange education sessions for team members and staff
• Arrange and advertise access to relevant websites for team members and staff
• Develop and implement interventions
• Evaluate interventions
• Write up final report

Step VI: Tasks

• Get sign off for project from NUM
• Finalize and review the project plan
• Obtain baseline data
• Establish schedule for the project
• Establish and communicate meeting times and dates
• Arrange education sessions for team members and staff
• Arrange and advertise access to relevant websites for team members and staff
• Develop and implement interventions
• Evaluate interventions
• Write up final report

Step X: Quality Management Tools

• Cause and effect diagrams - to identify the problem
• Clinical indicator audit tools - to identify the problem
• Satisfaction Surveys - analyzing data
• Minutes of meetings - deciding on interventions
• Meeting agendas - deciding on interventions
• Check sheets - monitoring progress
• Histograms - presenting measurement of project impact
• Run charts - monitoring progress

Themes from qualitative data collection methods

Step XI: Project Budget

Part III

Administration and Monitoring Project

Meeting agenda - standard agenda record

Meeting minutes - standard meeting record

Monthly statistics of mental disorders - clinical indicator tool

Part IV: Finalization and Evaluation of the Project Title

The title of the project is “Reducing chronic kidney diseases at old age”.

Project Overview

A review of the data indicated that the incidence of chronic kidney diseases was significantly greater on this region when data were benchmarked with other regions. Due to the negative effect chronic kidney diseases can potentially have on the quality of life for older people, as well as the financial implications on the individual and organization, this project was conceived and commenced in December 2012. Outcome and process measures were identified and analyzed and evidence-based best practice guidelines informed the project interventions.

Project Objective

At the end of the 8 months project, chronic kidney diseases in this region will reduce by 50% from baseline data.

Agreed changes to the project objectives (if any)

Nil

Issue and Risk Summary

One of the main team leaders from the unit staff was transferred to another unit due to unavoidable circumstances and, therefore, was unable to participate fully in the project. A replacement was done with immediate effect. This new team leader member had to be educated and informed about the team progress in order to become an active participant of the team (Nijsten, 2010).

Recommended Improvement

•  Ensure education is available for all relevant stakeholders using a variety of education modes e.g. face to face lectures, on-line learning resources, self-paced learning activities
• Ensure work load is distributed among all team members
• Ensure surplus member to take care of the emergency
• Ensure surplus capita to care for the deficits 
• Provide template for reporting at the beginning of the project.