Potential Barriers to Effective Planning to Transition of Care - Case Study Example

Potential Barriers to effective planning to transition of care Introduction Transitional care involves a wide range of environments and services which are designed to promote timely and safe passage of patients between different levels of health care as well as across health care settings. Quality transitional care is particularly important for frail patients and for those patients suffering from complex therapeutic regimens and multiple chronic conditions. Such patients usually move frequently within healthcare facilities and receive health care services from many providers (Coleman 2003, p. 551). Evidence from studies indicates these patients are especially prone to breakdowns in health care and they therefore need transitional care services most. Poor transition of these patients from hospital to home or from one health care facility to another is linked to high re-hospitalization rates, low satisfaction with care, and adverse events. There is therefore need for effective planning to transition of care to ensure that there is a smooth movement of patients from one point to another without the risk of re-hospitalization or development of other health complications (Halasyamani et al 2006, p. 355). However, there are various potential barriers to effective planning to transition of care which makes it hard for health care facilities and personnel to ensure a smooth and eventless transfer of patients from one point to another. In this paper, an analysis of the potential barriers to effective planning to transition of care in the provided case study will be carried. In the case study provided, a young girl named Jessica is suffering from asthma requires specialized treatment and constant monitoring from various health care practitioners and facilities. Although her transition through various stages of treatment and care has been planned, there are various potential barriers to this planning. One of the potential barriers is communication. Although there can be a proper on how Jessica should be transferred from one point to another in the health care setting, poor communication between the various facilities and personnel can hinder the transition making Jessica to fail to be provided with the necessary care that she needs to recover from her condition. Health care settings are composed of various departments and sections and in some cases, communication between the various departments and sections can hard (Kripalani, Jackson, Schnipper & Coleman 2007, p. 317). These departments and sections are prone to communication breakdowns, with information from one section failing to reach the intended destination. As a result, the departments and sections fail to coordinate well in terms of providing the needed care to patients. Communication breakdown in the health care facility that Jessica is admitted can see her fail to receive the intended medical attention that would allow for her quick recovery. Communication breakdown between various sections responsible for Jessica’s welfare also means that it will be hard to plan for Jessica’s transition because it will be hard to get all the needed information necessary for planning. For effective planning to be carried out, there is need for all the necessary information to be available. For instance, there is need for information on whether the needed resources and personnel that can facilitate the provision of the required care are available (Scal 2002, p. 1316). This therefore allows one to plan according to the available resources. Communication breakdown in this care therefore makes it hard for effective planning to be carried out since it will be hard for one to collect all the needed information from the departments, sections, and personnel involved in Jessica’s care. Communication breakdown does not only involve the different sections or institutions of a health care system but it can also involve the breakdown in communication between the hospital and the patient. Transition of care has to also involve the patient or the family of the patient. This is because the patient also takes part in ensuring the transition is smooth. In some cases, health care facilities do not inform patients or their families about the transition or the need for the transition (McDonagh 2005, p. 367). These decisions are made without consulting with them. Studies carried out on the issue of communication reveal that most family members are always not involved in the planning of transition or are not told about the need for the transition and the role they can play after the transition. In most cases, families of patients are only informed of the transition when they inquire. For the transition from hospital to home, most families are only instructed on what they should in various cases. Their own schedules are involved in the planning (Scal et al 1999, 261). For instance, they can be informed that they should administer drugs at a certain time of the day. However, in some cases, such families are not around to carry out such activities. As a result, patients experience. Failure to communicate to Jessica’s parents about the need for transition and the role they can play in the transition and what they should do should the transition involve moving from the hospital to home can result to recurrence of the problem. Another potential barrier to effective planning is lack of skills. Although there can be a proper plan on how Jessica should be cared about, lack of skills for various individuals taking part in the care makes it hard for effective planning to take place. This is because any planning has to involve the level of skills of the people involved. Developing a plan that requires high levels of skills makes it hard for one to implement since the available personnel will not be able to execute the plan (Carpenito 2014, p. 61). The issue of lack of skills can be experienced particularly among home caregivers. Most home caregivers do not have the necessary skills to provide the needed care as prescribed by the hospital. Transition planning for Jessica can therefore be greatly hampered by the lack of skills among home caregivers should the hospital decide to discharge her so that she can get medical attention from home. This is because the plan that will be put in place will have to factor in the limited skills that the caregivers. This means that it is hard to develop the most effective plan since there are no qualified individuals to implement the plan. The organization of the health care delivery system is also another potential barrier to effective planning of transition of care for Jessica. The healthcare system is fragmented into distinct and independent institutions. These institutions or sections work alone without any coordination with other institutions in the system. The autonomy of different sections within a system means that each system has its own way of doing things and is guided by different rules and regulations (Cambridge & Carnaby 2005, p. 78). This implies that coordination of the different sections within the same system is hard since there are no similar rules or guidelines that determine how each section functions and which can help the sections or institutions to come up with a common way of doing things. As such, developing a plan that caters for all the sections involved in providing Jessica with care is hard. The autonomy of the different sections also means that it is hard to bring all the involved sections or individuals to work together in order to develop a plan that will allow for a smooth transition of Jessica from one section to another. Due to this constraint, the formulated plan is likely to miss out on some sections involved making it less effective. There is also the issue of financial constraints for the individuals or institutions involved in the implementation of the plan. Although it was possible to formulate a plan that could help in providing multifaceted care to Jessica, financial constraints could play a role in determining the kind of plan adopted (Vincent 2010, p. 102). The financial constraints could be on the part of the system or Jessica’s family. For instance, implementation of a certain plan could lead to prohibitively high cost for the institution making it uneconomical for the health care facility in which Jessica was admitted to implement the plan. On the other hand, the proposed plan might require Jessica’s family to incur high costs making it unaffordable. The financial constraints can therefore act as a barrier to development of an effective plan to transition of care. Stereotypes that exist about certain groups of people can also be a potential barrier to effective planning of transition of care for Jessica. In any society, there are stereotypes that are formed about certain groups of individuals. Stereotypes are normally unfounded beliefs about the traits of certain people which other people believe to be true and which they use to define other individuals. Stereotypes are normally as a result of prejudice or lack of knowledge about certain people (Bryant & Nix 2012, p. 56). For instance, in early 1800s, black slaves in the US were believed to have less intellectual ability. Whites believed that black people did not have the ability to think properly and that they were more of animals than human beings. This made many white slave owners to treat their black slaves badly and ruthlessly. They felt that black people could only understand by been beaten. They also believed that black people are beastly and had to be subdued through being beaten. This led to the suffering of black slaves in the hands of white slave owners. However, eventually, they realized that black people had the same intellectual capacity as white people. Similar stereotypes formed against Jessica or her background can negatively affect the planning for her transition to care since such stereotypes will inform the decisions made by the health care facility concerning her. This might result to development of a plan that does not fit her needs thereby resulting to more complications. Decisions based on racial inclinations can also affect the planning of transition of care for Jessica. Although there has always been a fight against racism and people making decisions based on racial biasness, racism still continues to be a problem in the world today. It is common to see people from different racial groups being treated differently (Kripalani, Jackson, Schnipper & Coleman 2007, p. 319). For instance, the justice in the US is known to treat black individuals unfairly. This is seen in the high number of black inmates as compared to the white ones. This also applies in many institutions with certain racial and ethnic groups being treated differently as compared to others. using race as a basis for planning for transition for Jessica can result to problems as the planning can be done in a haphazard manner if Jessica is not favored by people in the health care facility she is being treated. This can therefore make Jessica’s race to a barrier to effective planning for transition of care. The social settings at home can also impede effective planning for Jessica’s transition. Jessica’s mother has to take care of both Jessica and the grandmother. This is overwhelming for her since both of them require a lot of attention. Jessica’s condition requires that her mother should be monitoring her constantly. However, this is not possible since she has to also take care of other issues. This therefore makes it hard for the health care facility to effectively plan for transition of care for Jessica especially if the transition involves moving from the hospital to home (Scal 2002, p. 1318). The inability of Jessica’s mother to monitor Jessica for 24 hours a day makes planning for home care to be a challenge. For instance, Jessica’s mother needs to sleep at some point because of fatigue. This means that she will not be aware of any changes in her daughter at that time. As stated in the case, at times she just woke up to find Jessica having breathing problems. If, for instance, she fails to work up at night to check on Jessica, chances are it can be fatal since Jessica can develop complications in the night where she might need attention from her. This limit of her ability to provide constant monitoring of her daughter in order to determine if she needs any special attention becomes a problem when planning for transition. This is because this limit in the social settings at home has to be factored in the plan, which in turn makes it to be less effective. Cultural and religious inclinations can be also be a hindrance to effective planning for transition. Each person in the world comes from a certain cultural setting which its rules and values. In most cases, values and beliefs from one community, cultural or religious group differ from the beliefs and values held by another cultural or religious. This makes it hard for one to come up with standard values that can be applied in all cases. Health care facilities and practitioners normally try to use standard practices on all patients. However, some of the practices contravene the cultural or religious beliefs of certain people. This makes it hard for health care professional to provide medical care for those individuals whose cultural and religious beliefs the practices at the health care facility contravene (Halasyamani et al 2006, p. 357). For instance, Muslims forbid contact between men and women if they are not married. Such a scenario can make it hard for male health care practitioners to provide health care services to a Muslim woman. Likewise, it can be hard for a female health care professional to provide health care services to a Muslim man. Occurrence of such cultural and religious in the case of Jessica can make it hard for the health care facility she is being treated in to plan for effective transition of care. This is because the plan will have to feature the cultural and religious constraints which can result to reduction in the effectiveness of the plan. The capacity of health care facilities and families to implement the proposed plan can also be a constraint to effective planning for transition. In some cases, health care facilities do not have the capacity to implement the planned transition. For instance, health care facilities might not have the necessary equipment that can allow for the transfer of a patient from one health care unit to another. The facilities might also lack the needed personnel who can provide the needed expertise for the transition (Coleman 2003, p. 553). In the case of Jessica, the facilities that she might need to be transferred to might not be having the necessary that can be used to treat her condition. For the transition from hospital to home, Jessica’s home might lack the capacity in terms of the setting to take care of her frail condition. This can result to development of further complications and therefore lead to re-hospitalization. Due to potential barriers to effective planning of transition of care for Jessica, there is need for the health care facility to carry out a number of things to ensure that the potential barriers are overcome. One of them is initiate channels of communication among all the stakeholders involved in taking care of Jessica. For instance, the hospital should ensure that all health care professionals involved with the treatment and care of Jessica are thoroughly informed about her condition. They should be informed of her history with asthma and the times when the attack persists. Clear communication will ensure that transition from one facility to another will be effective. In addition, it will ensure that the needed care is provided for Jessica. Jessica’s family should also be informed fully about their daughter’s condition and the role they play to ensure that she recovers quickly (Bryant & Nix 2012, p. 72). In case of the transition from hospital to home, the hospital should inform Jessica’s family concerning her condition and the necessary preparations that should be carried out to ensure that the transition is smooth. The family should also be involved in the planning so that their limits to provide the needed care can be factored in the planning. Informing the family will also ensure that the family understands what is required of them and will make the necessary arrangements to make sure that Jessica gets the needed care. The health care facility should also ensure that it factors the socioeconomic status of Jessica’s family, its cultural practices, and the capacity of the family to provide the needed care to Jessica in its planning. Conclusion Transitional care involves a wide range of environments and services which are designed to promote timely and safe passage of patients between different levels of health care as well as across health care settings. There are a number of potential barriers to effective planning of transition of care in Jessica’s case. They include communication breakdown, socioeconomic constraints in the hospital or family, stereotypes, and cultural and religious constraints. These constraints can result to development of a less effective plan which can in turn result to recurrence of the problem for Jessica. Bibliography Bryant, R. A., & Nix, D. P. 2012, Acute & chronic wounds: current management concepts, St. Louis, Mo, Elsevier/Mosby Cambridge, P., & Carnaby, S. 2005, Person centred planning and care management with people with learning disabilities, London, Jessica Kingsley Publishers. Carpenito, L. J. 2014, Nursing care plans: transitional patient & family centered care, Philadelphia, Wolters Kluwer Health Coleman, E. A. 2003, Falling through the cracks: challenges and opportunities for improving transitional care for persons with continuous complex care needs. Journal of the American Geriatrics Society, vol. 51, no. 4, pp. 549-555. 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