NHSFPX-8002_EndresTraci_Assessment 2-1

1 Demonstrating Effective Leadership Traci Endres Capella University NHSFPX-8002: Collaboration, Communication, and Case Analysis for Doctoral Learners Dr. Kathleen Zajic July 31, 2023

2 Demonstrating Effective Leadership Opioid misuse and deaths among adults have substantially increased over the past two decades with almost 72,000 deaths in 2017 alone ( Hudgins et al., 2019). The National Center for Drug Abuse Statistics (n.d.) indicates over 48,000 people experienced an opioid overdose in 2020, and nearly 4% of adults in America abuse opioids yearly. According to the Illinois Department of Public Health (n.d.) deaths related to synthetic opioid use have increased by 2,736% since 2013 which ranks Illinois as 24 th in the nation for drug overdose fatalities in 2019. The focus of this assessment is the state of Illinois, specifically Hancock County to analyze contributing factors and their impact contributing to this health concern, identifying high risk and affected groups including environmental, social, and financial factors along with forming a collaborative, interprofessional coalition to mitigate this chronic population health concern. Factors Contributing to Opioid Addiction The World Health Organization (2021) asserts that there are several risk factors for opioid misuse and overdose including using prescription medications without the supervision of a provider, using high prescribed dosages, injectable routes of administration, previous opioid addiction or disorder, and concurrent medical conditions such as chronic pain. In 2020, opioid prescription dispensing rates remained high across the country with nearly forty-four prescriptions written per one hundred people with some counties having rates up to nine times greater (Centers for Disease Control [CDC], 2021). Additionally, it has been shown those that are Caucasian without college degrees in rural areas with decreasing employment opportunities are among those with the highest mortality rates related to prescription drug overdose and misuse in recent years ( Salmond & Allread, 2019).   An

3 important finding in a recent study conducted by Altekruse et al. (2020) indicated the risk for opioid misuse is greater among people in low socioeconomic status groups such as young adults and Caucasian men related to social and economic despair with poor opportunities in struggling communities. The United States Census Bureau (2022) estimates the population of Hancock County, Illinois is 17,244 with ninety-seven percent being Caucasian. The website reveals the median household income of the county is $58,188 and almost twelve percent of the population currently lives below the poverty threshold. The Bureau explains the poverty threshold is measured by specific income thresholds and if the total family income is less than the level for the size of the family, they are within poverty level. As a population health concern, the opioid epidemic is one of the worst public health issues in the Canada and the United States and it is estimated that an additional one to two million people could be victims of this epidemic by 2029 (Lancet Public Health, 2022). Salmond and Allread (2019) assert it is imperative to look at the entire crisis in the setting of population health and incorporate key partnerships utilizing evidence-based prevention and treatment interventions. Coalition to Address the Opioid Epidemic Creating an effective coalition to mitigate opioid misuse in Hancock County will require multiple interprofessional partnerships. Healthcare providers, clinicians, and the county health department along with those from various government sectors such as police and public safety individuals can provide valuable information on treatment, data, and statistics on opioid misuse and overdose. In addition, key community representatives from multiple communities in the county such as city government officials and other community members can provide insight into the state of the county. The coalition will examine and review social determinants of health,

4 access to treatment, locally available treatments, gaps in care, health disparities, and community attitudes toward opioid addiction ( Salmond & Allread, 2019).   The coalition team members and their contribution are listed in the following table. Table 1 Coalition Team Members and Their Contribution Coalition Team Members Contribution Dr. E.M., Emergency Medicine-Carthage Memorial Hospital, key community member Provide insight and education on opioid misuse, addiction, and overdose cases being seen in the ED. Can provide data on outcomes and frequency of recurring visits by the same patients. J.H., CADC, BSW, Certified Alcohol & Drug Counselor-Memorial Medical Clinic, Carthage, key community member Collaborate with Dr. E.M. and C.B to provide education to coalition members regarding opioid treatment and rehabilitation best practices and formulate a strategy for addiction and prevention, recovery, and rehabilitation C.B., DNP, FPA-APRN, PMHNP-BC, CPNP-PC, MBA, Director of Behavioral Health Services- Memorial Medical Clinic Collaborate with Dr. E.M. and C.B to provide education to coalition members regarding opioid treatment and rehabilitation best practices and formulate a strategy for addiction and prevention, recovery, and rehabilitation M.C., APN-Hancock County Health Department Board Member, general practice nurse practitioner, key LaHarpe community member Provide valuable data on community and county opioid misuse and addiction from both a health department and general provider perspective. Data can also help determine areas of the county that are seeing increasing opioid trends. M.C. lives in a neighboring community and is an active member of that community Dr. L.J. Smith, Hancock County Health Department Board Member, key community member Provide valuable data on community and county opioid misuse and addiction from both a health department and general provider perspective. Data can also help determine areas of the county that are seeing increasing opioid trends to better focus to address this health concern C.W., Pharm D-Wear Pharmacy, active Carthage community member C.W can provide data on the number of opioid prescriptions being written along with any trends on specific communities, health centers, and providers to provide additional focus to address this issue J.N., Mayor of Carthage, active Carthage community member The mayor of the largest town in the county will have the greatest chance of reaching the most community members to provide information regarding the work the coalition is doing to reduce opioid addiction as well as promote community and county involvement. A.F., Hancock County Emergency Medical Service Coordinator The EMS coordinator can contribute valuable data on the trends of service calls across the county related to overdose. This can help the coalition to improve focus in those areas and determine if services related to addiction are lacking in those communities T.D., Hancock County Sheriff, key community member The county sheriff and his office have information on drug-related incidents and trends across the county. He can also provide insight on surrounding counties to determine if the data may somehow be related to increase prevention measures.

5 Issues Affecting Coalition Collaboration Interprofessional collaboration has become commonplace with adoption of collaborative care in the primary care setting. This ensures all patients receive all the care they need at the right time from the right discipline to achieve the best outcome. Multiple issues can affect the efficacy of the coalition including poor communication, ill-defined roles, and responsibilities, lingering ideas of traditional hierarchies, differing cultures, and work styles, inefficient and inaccurate data, and doubts about the effectiveness of interprofessional collaboration ( Rawlinson et al., 2021). Failure to acknowledge another profession’s perspectives, thought processes, and approach to this health concern as well as a lack of appreciation for the other profession’s knowledge base and skill set can also lead to poor performance and outcomes related to interprofessional collaboration ( Hager et al., 2018). Strategies to Optimize Collaboration Jenkins (2021) notes the effectiveness of a coalition can be enhanced when each member recognizes the unique and specific skill set, contributions, strengths, and knowledge each person brings to the team. This helps to build a culture of respect, trust, and autonomy. He further explains accountability and professionalism are two important concepts to be contemplated to improve trust and respect. According to McLaney et al. (2022) the Sunnybrook framework for interprofessional collaboration was developed at the Sunnybrook Health Sciences Centre in Toronto, Ontario to address gaps in interprofessional teamwork and collaboration. The framework consists of six core competencies that can be applied to varying types of teams. They further explain the six