American General Hospital Website: https://rnheartamericangeneralhospital.godaddysites.com/

Background: DME Policy

American General Hospital (AGH) is considering a policy change for patients being discharged in need of durable medical equipment (DME).  The DME includes, but is not limited to: rolling walkers, axillary crutches, straight canes, commodes, and tub seats. American General Hospital wants to determine which of two policy solutions to pursue for these patients.

American General Hospital (AGH) routinely discharges patients to home with a need for one or more durable medical equipment (DME). The current policy at AGH instructs to educate the patient and family regarding the DME needed and to provide them with the prescription. The patient/guardian has the responsibility of obtaining the DME as well as any financial responsibility not covered by insurance (See DME Discharge Policy). Prior to the pandemic, AGH became aware of a trend of increased numbers of patients discharged with a prescription for DME who never acquire the DME and medical supplies for various reasons (number unknown). The DME Discharge Policy is due for renewal. The hospital Policy and Procedure committee will meet in 5 weeks. The Board of Directors at AGH would like to review the recommendations as they consider strategic plans for post-pandemic operations.

Challenge Statement: Policy

In this challenge, the learner will assume the role of the advanced-Nurse representative on the hospital Policy and Procedure Committee. Policies are designed and reviewed using the evidence-based practice model. Your assignment is to evaluate two options related to the provision of DME and present your findings and recommendations to the committee. The evaluation must include considerations of patient safety and quality, regulatory guidelines, ethical-legal constraints and liability, financial impacts, and institutional structures and stakeholders. Pros and cons for each option should be presented with evidence-based rationales. Implementation and evaluation strategies should also be a part of the final recommendations. Conclude with considerations of implications for AGH and the community.

Outcome Goal:

Evaluate both of the following options and make a firm evidence-based recommendation for one of the options to the AGH stakeholders for their final decision.

Option One:  Renew current policy whereby AGH will provide a written prescription at discharge to the patient or guardian for the necessary DME for use at home. The patient/guardian is responsible to purchase and obtain the DME.

Option Two: Revise the current policy. AGH will provide select DME prior to patient discharge and will assume billing and reimbursement responsibilities. AGH will facilitate vendor purchase and delivery for equipment and supplies not kept in stock at the hospital.

Durable Medical Equipment Executive Summary Guidelines and Rubric

The Executive Summary should written in professional APA style 7th Edition. 

– Double Spaced throughout; 1-inch margins

– 11 point Arial or Calibri font

– Cover page in APA 7th edition style for academic papers

– Citations and Reference list 

– Do not use first person

– Recommended length: 8-10 pages. 

o The length is a guideline. You may write as much or as little it takes to hit all of the elements listed above. 

The Executive Summary should include the elements from the Executive Summary Worksheet

1. Introduction (Remember do not use the heading Introduction.)

Introduce the challenge and the purpose of this executive review (one paragraph)

2. Present the Challenge

Explain the challenge statement: your role, the options, and the goal 

3. Background and Significance

Explain the setting (AGH). Summarize the stakeholders’ interests, identifying the significance from the stakeholder’s perspectives. 

4. Context: EBP Methodology

Explain the EBP methodology used to explore the topic of the challenge. For example, choose an EBP model used to approach the topic. Describe the selection process for the literature search.

5. Identification, Critique, and Analysis of Evidence

A full literature review is not included in the executive summary, however, key findings should be reported and include the following items at minimum:

– Patient Safety and Quality

– Regulatory Guidelines

– Ethical-Legal Considerations

– Liability

– Institutional structures and Stakeholders

Financial impact

In the Executive Summary, synthesize the literature review.

6. SWOT Analysis: 

Summarize the key points from the SWOT analysis; Use the SWOT diagram to illustrate the overall SWOT. Include graphs or tables for data that support analysis of SWOT elements. 

7. Key Findings: Pros and Cons for Options 1 and 2 

Summarize the pros and cons for each of the two options. 

Use evidence to support your analysis.

8. Final Recommendations and Rationales 

Clearly state the option choice and rationale. 

Comment on any further recommendations and rationale, including implementation and evaluation strategies. Address potential implications for AGH and/or the community.

9. Add full reference list below the table

Policy Challenge Executive Summary Rubric

Competencies

1. Analyze healthcare systems and their impact on decision-making and health care delivery.

2. Integrate research findings into clinical decision-making for quality improvement.

3. Generate data-driven solutions to address operational challenges with service models and reimbursement, advocating for ethically responsible and financially effective strategic planning.

4. Demonstrate leadership and professional practices by assessing stakeholder relationships, and leveraging technology to influence strategic decision-making. 

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