Write a brief introduction (2 to 3 sentences) to your proposal that outlines the issue you are attempting to solve, the part of the organization in which the plan would be carried out, and the desired outcome.
Interdisciplinary Plan Proposal
An interdisciplinary plan is a detailed plan of care developed by healthcare providers from the various professionals who make up the healthcare team. During the planning process, each health professional’s input is considered and weighed against the benefits and risks to patients. In the previous assessment, I interviewed a geriatric nurse practitioner (GNP) in a long-term care facility where we identified polypharmacy as a major problem. The interdisciplinary plan is a comprehensive interdisciplinary medication review in the inpatient setting of the facility to reduce polypharmacy. The purpose of this paper is to discuss the best practices of interprofessional collaboration, change theory, leadership strategies, and organizational resources that can be employed to address polypharmacy.
The interdisciplinary team will assess the risks and benefits of each patient’s prescribed and OTC medicine and make decisions about maintaining or removing the drug from the treatment plan. The healthcare team will have shared decision-making, which will help reduce the number of prescribed drugs for each patient (Bosch-Lenders et al., 2021). If polypharmacy is reduced by decreasing the number of drugs per patient, the plan will improve patient outcomes by reducing adverse drug events and lowering the overall cost to patients and the organization.
Questions and Predictions
- How will the team know the medications a patient is using? The team will extract the number of medications from the physician’s and pharmacist’s patient records at the beginning of the intervention and follow-up.
- How will the interdisciplinary team know the changes they have made to a patient’s medication plan? Any changes made to the pharmacological plan will be compared to the medication list of the former assessment and will be based on a patient’s report to avoid the concordance between medicines prescribed, medication dispensed, and the medication used (Mangin et al., 2021). The team will utilize patient reports on actual use to assess changes made
- How will reducing polypharmacy promote medication adherence among patients with chronic illnesses? Polypharmacy is linked with reduced medication adherence. Thus, reducing the number of medications will motivate patients to comply with their prescribed therapy (Mangin et al., 2021).
Change Theories and Leadership Strategies
Ronald Havelock’s change theory will use in implementing the comprehensive interdisciplinary medication review plan to address polypharmacy. The theory has six phases of change: Building a relationship; Diagnosing the problem; Acquiring resources; Choosing a pathway for the solution; Gaining acceptance; Maintaining and Separating (Udod & Wagner, 2018). The theory will promote knowledge building, effective communication strategies, staff response approaches, and support systems when implementing the interdisciplinary plan. Furthermore, the change theory will help identify the changes needed to lower the number of patients facing polypharmacy in the facility.
Participative leadership is one of the leadership strategies that will be employed in implementing the interdisciplinary plan to address polypharmacy. It will entail the team leader involving all the members in decision-making. The leadership strategy will encourage collaboration in the interdisciplinary team by fostering accountability in individual roles and members collaborating to identify solutions. Besides, it will help build trust by showing the importance and value of the team’s opinion on important issues (Smith et al., 2018). Thus, participative leadership will help develop an interdisciplinary solution by having every interdisciplinary team member contribute to decision-making on the medications a patient should be prescribed and those that should be stopped.
Team Collaboration Strategy
The comprehensive interdisciplinary medication review plan will be implemented by a team comprising physicians, nurses, and pharmacists in partnership with patients. Collaboration will be fostered in the interdisciplinary team through effective communication skills by the team leader (Rosen et al., 2018). The team leader will be expected to employ communication strategies that promote intra-team communication, collaborative decision-making, and effective team processes.
The roles of each team member will be outlined, and the members will be required to respect each other’s roles to promote interdisciplinary team collaboration. The nurse’s roles will include making a complete medication list for each patient, assessing the medications’ adverse effects, and correct/incorrect intake of medications by the patient (Bosch-Lenders et al., 2021). The physician will modify the patient’s treatment plan by prescribing medication identified as suitable for the patient. The pharmacist will check the prescribed medication for an indication as recorded in the patient’s record by the physician. Additionally, the pharmacist will evaluate a patient’s prescribed medications for side effects, adverse effects, contraindications, and drug-to-drug interactions to ensure drug safety (Bosch-Lenders et al., 2021). This will be crucial in creating and maintaining a strong interdisciplinary health team to implement the plan to address polypharmacy effectively.
Required Organizational Resources
Implementation of the interdisciplinary plan will require human, technological, and financial resources. The staffing needs will include physicians, nurses, and pharmacists. Technology resources will include the electronic health record (EHR) and computerized decision support system (CDSS) to save time (Thiruchelvam et al., 2022). Fortunately, the long-term care facility has adequate physicians, nurses, and pharmacists to conduct the medication review and has incorporated EHR and CDSS technology in the clinical workflow. However, costs will be needed to use the technology resources since the developer will be consulted on how the systems can be used to facilitate the medication review process. The overall financial budget for the proposal is estimated at $ 90,000. This covers payments to developers and team members for the additional work. Therefore, if the plan is unsuccessful, the organization will face a financial loss and demotivate the team members.
Polypharmacy was identified as an issue in a long-term care facility, and the proposed solution is a comprehensive interdisciplinary medication review. The desired outcomes are to improve patient outcomes, safety, and satisfaction by reducing the number of prescribed drugs. Havelock’s change theory will be used to implement the interdisciplinary plan because it emphasizes applying scientific knowledge to establish the measures that best promote change implementation. Team collaboration will be fostered by the leader, making the interdisciplinary team members feel they are listened to and can speak out within a team context, including discussing and solving challenges within the team. Each team member will be expected to respect and understand other members’ roles and how they can impact patients.
Bosch-Lenders, D., Jansen, J., Stoffers, H., Winkens, B., Aretz, K., Twellaar, M., Schols, J., van der Kuy, P. M., Knottnerus, J. A., & van den Akker, M. (2021). The Effect of a Comprehensive, Interdisciplinary Medication Review on Quality of Life and Medication Use in Community-Dwelling Older People with Polypharmacy. Journal of clinical medicine, 10(4), 600. https://doi.org/10.3390/jcm10040600
Mangin, D., Lamarche, L., Agarwal, G., Banh, H. L., Dore Brown, N., Cassels, A., … & Thabane, L. (2021). Team approach to polypharmacy evaluation and reduction: study protocol for a randomized controlled trial. Trials, 22(1), 1-15. https://doi.org/10.1186/s13063-021-05685-9
Smith, T., Fowler-Davis, S., Nancarrow, S., Ariss, S. M. B., & Enderby, P. (2018). Leadership in interprofessional health and social care teams: a literature review. Leadership in Health Services. https://doi.org/10.1108/LHS-06-2016-0026
Thiruchelvam, K., Byles, J., Hasan, S. S., & Kairuz, T. (2022). Innovating medication reviews through a technology-enabled process. Research in social & administrative pharmacy: RSAP, 18(4), 2700–2705. https://doi.org/10.1016/j.sapharm.2021.07.019
Udod, S., & Wagner, J. (2018). Common change theories and application to different nursing situations. Leadership and Influencing Change in Nursing.