NURS FPX 6218 Assessment 1 Proposing Evidence-Based Change
University:
Capella University
NURS FPX 6218 Assessment 1 Proposing Evidence-Based Change
Paper Instructions
Propose a change to one aspect of your local or regional health care system or program that would improve outcomes. Then, conduct a comparative analysis of other, non-U.S. health care systems, focusing on the proposed change. Summarize the proposed change and your comparative analysis in a 4-5 page report.
Introduction
Note Complete the assessments in the order in which they are presented.
Health care systems around the world provide useful models for analysis. Familiarity with different models and approaches to health care enables leaders to identify what works and what does not, as the basis for proposing a change. As we continue to evaluate the complex and fragmented system in the United States, it is important for nurse leaders to become familiar with the programs and systems that provide evidence-based quality care that is affordable and focused on continual improvement.
This assessment provides an opportunity to examine a local or regional health care issue from a global perspective.
Preparation
Your organization, in collaboration with the key stakeholders from the community, is funding an initiative to investigate potential improvements in the local or regional health care system. As a nurse leader attuned to the effects of health care policy and finance on the provision of affordable, high-quality care, you have been asked to join the task force conducting the study.
You know that an examination of other countries\’ health care systems can provide a solid, evidence-based foundation for evaluating outcomes and identifying benchmarks. Consequently, you have decided to undertake an analysis of selected, non-U.S. health care systems and compare them to each other and to the existing local or regional U.S. system to help inform decision making as the task force considers proposed changes.
In this assessment, you will propose a change to one aspect of your local or regional health care system or program. Conduct a comparative analysis of different health care systems and summarize your proposed change and findings from your analysis in a report to executive leaders. To prepare for your assessment, you are encouraged to begin thinking about the non-U.S. health care systems you might like to examine. In addition, you may wish to
- Review the assessment requirements and scoring guide to ensure that you understand the work you will be asked to complete.
- Review Guiding Questions Proposing Evidence-Based Change [DOCX], which includes questions to consider and additional guidance on how to successfully complete the assessment.
Note Remember that you can submit all or a portion of your draft report to Smarthinking Tutoring for feedback before you submit the final version for this assessment. If you plan on using this free service, be mindful of the turnaround time of 24-48 hours for receiving feedback.
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TEMPLATES
Use this template for your summary report.
- Summary Report Template [DOCX].
Requirements
Complete this assessment in three steps
- Propose a change to one aspect of your local or regional health care system or program that would improve outcomes.
- Conduct a comparative analysis of different health care systems, focusing on one aspect of the system you are proposing to change.
- Summarize your proposed change and the results of your comparative analysis in a report to executive leaders.
The summary report requirements outlined below, correspond to the grading criteria in the scoring guide for Proposing Evidence-Based Change, so be sure to address each point. Read the performance-level descriptions for each criterion to see how your work will be assessed. The Guiding Questions Proposing Evidence-Based Change document provides additional considerations that may be helpful in completing your assessment. In addition, be sure to note the requirements below for document format and length and for citing supporting evidence.
- Identify an aspect of a local or regional health care system or program that should be a focus for change.
- Define desirable outcomes, including who will pay for care and factors limiting achievement of those outcomes.
- Analyze two non-U.S. health care systems or programs that offer insight into a proposed change for a health care system or program in the United States.
Choose one of the following options for selecting the two systems or programs
- Option 1 Select two systems at opposite ends of the scale in terms of desirable outcomes for the issue reflected in your proposed change.
- Option 2 Select two systems that both produce positive outcomes but take unique or innovative approaches to the problem.
Compare the outcomes in each non-U.S. system with each other and with present outcomes in your local or regional health care system.
- Explain why specific changes will lead to improved outcomes.
- Determine the financial and health implications associated with the proposed changes.
- Address the implications of making the changes.
- Address the implications of not making the changes.
- Write clearly and concisely in a logically coherent and appropriate form and style.
- Support assertions, arguments, propositions, and conclusions with relevant and credible evidence.
Document Format and Length
Use the Summary Report Template. This APA Style Paper Tutorial [DOCX] can help you in writing and formatting your assessment. If you would like to use a different worksheet for your community health assessment, obtain prior approval from faculty.
- Your summary report should be 4-5 pages in length, not including the title page and references page.
- Be sure to apply correct APA formatting to all source citations and references.
Supporting Evidence
- Cite 3-5 credible sources from peer-reviewed journals or professional industry publications to support your comparative analysis.
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Sample Answer
Change Proposal Summary Report
The healthcare model used by a particular country determines how patient care services are offered; hence is a need to have an adequate understanding of the healthcare model applied in the country. Healthcare leaders also need to be familiar with various models and approaches to healthcare to enable them to identify aspects that are effective and that are not effective, hence forming the basis of a proposed change.
Such proposals for change can be effected in local or regional healthcare systems to help improve patient outcomes (Smith-Bindman et al.,2019). Therefore, the purpose of this assignment is to propose a change to an aspect of the local or regional healthcare system. In addition, this assignment will focus on a comparative analysis of other non-U.S. healthcare systems focusing on the proposed change.
Executive Summary
Proposed Change
This paper will focus on the U.S. regional healthcare system and, specifically, U.S. healthcare insurance. The USA healthcare insurance has been a topic of debate for several years, with a substantial number of U.S. citizens not having insurance. The implication is that such a large number of individuals, therefore, may find it hard and complicated to access healthcare services due to their inability to pay the needed cash for the healthcare services. As such, they can even succumb to treatable diseases which could have otherwise been treated if they had health insurance.
Currently, the U.S. health insurance system is, to a bigger percentage, a private insurance system that is supplemented by Medicaid and Medicare (Berchik et al.,2019). The proposed change is a modification of the current healthcare system to lean towards a universal health insurance coverage system. Therefore, it is expected that such a change would lead to a majority of the population accessing healthcare services. The evidence that supports my position regarding the change is that a substantial number of U.S. citizens remain uninsured even though the Affordable Care Act has improved the number of insured individuals.
Desired Outcomes
As pointed out earlier, the proposed change is to reform the USA healthcare insurance system; as such, one of the desirable outcomes of the proposed change is a change to a universal healthcare insurance system to offer coverage for every U.S. citizen so that each and every person can access the patient care services that they may need (Keisler-Starkey & Bunch, 2020). The implication is that every U.S. citizen would be able to access healthcare services since the costs will be reimbursed from the new initiative. The health coverage would include several basic healthcare needs and just leave out a handful of services that can be decided once a suitable framework has been put in place.
The new proposed universal healthcare insurance system will need to be funded, and so, as part of the proposal, the new system is to be paid for by every USA taxpayer. The payment rates for every those who pay will have to be regulated by suitable enacted laws. For example, every citizen would be required to contribute a part of their income to support the new health insurance system. Appropriate calculation of the percentages would ensure that the payments are fair to support the system as appropriate and that the payment system would ensure that everyone gets healthcare services.
The proposal of the universal healthcare system can help solve the problem of inadequate access to healthcare services which has seen a substantial number of American citizens not being in a position to obtain the needed healthcare services. Nonetheless, there could be various limiting factors that can hinder the implementation and acceptance of the proposed universal healthcare insurance system. One such factor is the lack of political goodwill from the political class who make and implement laws.
There is still a belief that the universal health instance is associated with socialist ideology and should not be accepted in countries that believe in capitalism as the USA. The other potential limiting factor is the strong presence and influence of the private insurance companies that have been engaging in offering coverage and have an influence on politics and government policies.
Health Care System Comparative Analysis
It is important for healthcare leaders to have appreciable knowledge regarding the healthcare systems of other nations so that they can make informed decisions regarding any potential changes to the existing system. As such, the Canadian and French healthcare insurance systems have been chosen for the comparative analysis. These two systems have substantial differences from the U.S. healthcare system, which is largely privatized. In the two counties, the health insurance systems put in place by each government offers health insurance coverage to almost all their citizens.
Healthcare insurance in both Canada and France advocates for solidarity and equality in how healthcare should be obtained (Ranabhat et al.,2019). The two countries have their universal healthcare system hinged on the respect for human dignity principles. Hence individuals are able to seek healthcare services even though the costs may be high.
The universal healthcare systems offered by France and Canada give universal coverage to their citizens for better patient outcomes. However, they both have limits on health insurance coverage. For example, the French universal healthcare system excludes dental and eye care from coverage, implying that individuals have to use supplementary insurance when accessing such services (Ranabhat et al.,2019). Comparatively, the Canadian universal healthcare system excludes home healthcare and drugs from the coverage (Smith-Bindman et al.,2019).
In most cases, the Canadian and French universal healthcare systems have for a long time been viewed as superior to the healthcare system in the U.S. in terms of accessibility and focus on quality care. In various rankings, the two nations have always been ahead of the U.S. healthcare system and health insurance (Smith-Bindman et al.,2019). Such rankings are usually based on various outcomes. As such, the Canadian and French healthcare systems both support more access to healthcare. They also support healthcare equity as compared to the U.S. through the universal healthcare system.
The rationale for the Proposed Change
As discussed earlier, the current U.S. healthcare system is largely private and supported by Medicaid and Medicare. Therefore a proposal is here given for change to a universal healthcare system where American citizens will pay for the insurance using calculated percentages to help support a universal healthcare system (Berchick et al.,2019). Therefore, the rationale for choosing this change or approach is to ensure that all citizens have access to the needed healthcare service. The other rationale is to improve the quality of care offered to patients across all economic classes without the fear of having to pay extremely high bills.
Financial and Health Implications
The proposed universal healthcare system has great potential to improve access to care and the quality of patient care services offered to patients. However, the proposal has financial and health implications. One of the financial implications is that the working class paying taxes will have to pay to help the system work. For example, the new system may work as a tax system where individuals contribute depending on the value of their salary in the form of tax revenue (Berchick et al.,2019). The federal and state government will also have to sponsor part of the health care insurance. However, private medical insurance will also need to be in existence to cover the services not covered in the proposed universal healthcare system. In case no change is made, then then a notable number of citizens will continue not having adequate access to the healthcare services as they should.
Conclusion
This paper has focused on a change proposal to the U.S. healthcare system, focusing on healthcare insurance. The nature of the current healthcare care system, where the insurance is largely managed privately, has locked many individuals from getting adequate access to healthcare. As such, a proposed change to a universal healthcare system that will improve access to care and quality of care has been explored. The rationale for change is to increase health insurance coverage for American citizens. Increased insurance coverage may impact the quality of care positively and lead to better population health.
Appendix
Table 1: Health Care System Comparative Analysis
Table directions
- Add the names of the two non-U.S. healthcare systems and the local or regional U.S. healthcare system to the applicable column headings.
- In the first column, list each outcome. Add rows to your table as needed.
- Add the relevant information pertaining to each outcome for each healthcare system in the second, third, and fourth columns.
| Outcomes | Canadian Health care system | French Health Care System | U.S. Health Care System |
| Improve access to care | Has better access to care | Has better access to care | Comparatively lower access |
| Improved patient outcomes | Patients have improved outcomes | Patients have improved outcomes | Patients have improved outcomes |
| Quality service at affordable costs | The costs are relatively low compared to the USA | The cost is relatively lower | High costs due to privatization |
(Papanicolas et al.,2018), (Smith-Bindman et al.,2019)
References
- Berchick, E. R., Barnett, J. C., & Upton, R. D. (2019). Health Insurance Coverage in the United States, 2018 (pp. 60–267). U.S. Department of Commerce, U.S. Census Bureau.
- Keisler-Starkey, K., & Bunch, L. N. (2020). Health insurance coverage in the United States 2019. Washington, DC U.S. Census Bureau.
- Papanicolas, I., Woskie, L. R., & Jha, A. K. (2018). Health care spending in the United States and other high-income countries. Jama, 319(10), 1024-1039. Doi 10.1001/jama.2018.1150
- Ranabhat, C. L., Kim, C. B., Singh, A., Acharya, D., Pathak, K., Sharma, B., & Mishra, S. R. (2019). Challenges and opportunities towards the road of universal health coverage (UHC) in Nepal a systematic review. Archives of Public Health, 77(1), 1–10. https //doi.org/10.1186/s13690-019-0331-7
- Smith-Bindman, R., Kwan, M. L., Marlow, E. C., Theis, M. K., Bolch, W., Cheng, S. Y., … & Miglioretti, D. L. (2019). Trends in the use of medical imaging in U.S. health care systems and in Ontario, Canada, 2000-2016. Jama, 322(9), 843-856. Doi 10.1001/jama.2019.11456
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