Capstone Prospectus Task 2_ Clayton

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School

Western Governors University *

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991

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Health Science

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Feb 20, 2024

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docx

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Capstone Task 2: Prospectus By Omarah Clayton A. EXECUTIVE SUMMARY In the primary care office where I work, several elderly patients will miss their annual wellness visit required by Medicare. They will miss their essential follow-up appointments and the simple nurse visits for vaccinations because they need a reliable way to get to the doctor's office. Transportation barriers lead to rescheduled or missed appointments, delayed care, and cut or delayed medication use. These consequences may lead to poorer chronic illness management and, thus, poorer health outcomes. (Syed, Gerber, & Sharp, 2013) I propose that the institution I work for create a transportation system in which patients meeting specific criteria can catch a reliable way to their appointments without having to schedule their appointments around transportation that have the potential of leaving them stranded and worried. The transportation system will ensure that patients can assuredly get to their appointments without delay or worry. The patient would call the office and request a ride to, from, or both directions. The feasibility of this opportunity will address the ongoing challenge of the elderly and chronically ill keeping and attending their yearly and follow-up appointments. B1. CHALLENGE One primary purpose of visiting doctors' offices is to attain preventive healthcare as people age. Many of the patients seen in the BayCare Medical Group South Pasadena Primary Care office are geriatric patients. 56% of South Pasadena, Florida's population is over 65. (U.S. Census Bureau, n.d.) . The providers in the Pasadena practice treat mainly patients over 70, which seems like the entire area. Some patients have children who care for them from afar and are not available in transportation with their parents or family members who need to go to essential appointments. Many older adults have increasing transportation needs for medical appointments due to their decreasing physical and mental conditions at retirement age. ( Kotval, Keilman, & Wang, 2020). They either live alone in an assisted living facility or if they still have their spouse or partner, they live lonely without any additional help. B2. FACTORS Several factors contribute to the transportation challenges of the elderly and chronically ill. The main factors in South Pasadena, Florida, are the availability of wheelchair-accessible vehicles. (DOEA, 2022) The financial responsibility may plague patients living on fixed incomes (Data USA, n.d.) , and it may hinder them from keeping or even making annual appointments or

follow-ups needed for medication refills. The timeliness of the transportation seems to be an issue as well. Those patients can only get a meeting between certain times of the day that are usually more popular to those with regular transportation and can't get the much-needed time slot. The qualitative analysis of participants' transportation challenges revealed several themes, including availability, accessibility; safety; physical limitations/health concerns/pain; financial limitations; advanced planning and waiting; and societal attitudes. Table 3 includes challenge themes and illustrative participant quotes. (Remillard, Campbell, Koon, & Rogers, 2022) (Remillard, Campbell, Koon, & Rogers, 2022) B3. POTENTIAL RISKS The potential risks of this need not being addressed could be detrimental to the quality of life of the patients that suffer through not having the transportation needed. Not having a proper ride affects the healthcare outcomes that occur from missed appointments. Social activities become a thing of the past, and after a while, isolation becomes a reality for these patients. Loss of hope becomes a potential death sentence as health declines and care diminishes. Reliable transportation directly impacts health outcomes because it increases access to medical services. Lack of transportation can increase the risk of numerous health problems, from depression to cardiac arrest to early death. Furthermore, seniors, people with disabilities, or those without a vehicle who have limited access to public transportation can experience higher social isolation. (Wallace, Hughes-Cromwick, Mull, & Khasnabis, 2005).

B4. HEALTH OUTCOMES Reliable transportation directly impacts health outcomes because it increases access to medical services. Lack of transportation can increase the risk of numerous health problems, from depression to cardiac arrest to early death. Furthermore, seniors, people with disabilities, or those without a vehicle who have limited access to public transportation can experience higher social isolation. (Wallace, Hughes-Cromwick, Mull, & Khasnabis, 2005). Depression can have the worst impact on the elderly and chronically ill. Older adults are at increased risk. About 80% of older adults have at least one chronic health condition, and 50% have two or more. Depression is more common in people with other illnesses (such as heart disease or cancer) or whose function is limited. (CDC, September 2022) Depression affects healthy people exponentially, so you can only imagine what it can do to those with limited social cues and no transportation to get out about in the community. Lack of transportation can cause a domino effect of a lack of motivation to be mobile, which can impact a patient's health portfolio. Any illness left to fester will only increase the sickness, which will cost more to treat. (National Center for Mobility Management, October 2022) B5. HEALTHCARE COSTS Healthcare costs will always be affected by every aspect of what goes on in a patient's life. Healthcare costs can increase or decrease with transportation challenges and resolutions. Transportation can raise prices for patients' pockets but not as much as it would for declining health. Lack of transportation for patients may cause them to utilize nonemergency services instead of going to their primary care provider for regular maintenance treatment. The most common reasons patients may go to the E.D. related to access: are lack of a relationship with a primary care provider or care team, lack of after-hours or timely access to a provider, or barriers to access such as transportation. Other reasons may be more complex, including inadequate chronic care management or gaps in care coordination among multiple care locations. (National Center for Mobility Management, 2022). B6. DELIVERY OF CARE Delivery of Care would be value-based; patients would be the transportation department's focus and ensure they get to and from their appointments. The following categories are the ones that will be the focus: Patient cost reduction, Increased Patient Satisfaction, and Society becoming healthier. Hopefully, the healthcare world will continue to move in a direction that lowers costs, places patients at the center of care, promote teamwork and clear communication, and creates an overall healthier society. (Oak Street Health, 2022)

B7. STAKEHOLDERS Some internal stakeholders participating in the transportation initiative will be the CEO, CFO, and RMO of Baycare Health System. The external stakeholders are Wheelchair Transport Services, YMCA, and Mercedes-Benz Vans. Chief Executive Officer: The CEO will oversee the entire implementation of the transportation department adding to the Baycare Health System. Chief Financial Officer: The CFO will review all the financial responsibilities encountered by Baycare Health System. The revenue will be obtained, then the prediction of how long it will take for the department to start paying for itself. Risk Management Officer: The RMO will research and review the liability to start the transportation department at Baycare Health System. They will interview vendors for insurance companies and insurance plans to implement the new department. The best coverage for the best price and range can have to most drivers. Wheelchair Transport Services: Collaboration with WTS will allow Baycare Health System to outsource overflow services for patients outside the mile radius who live too far from their primary care office. Our independent contract drivers depend on you for their livelihood and are, therefore, much more sensitive to your needs and strive to make your experience pleasant. Our company mission is, very simply, to provide our clients with the most satisfying experience one can have while traveling in one of our vehicles. (Wheelchair Transport Services, 2022) YMCA: Affiliation with the local YMCA centers throughout various communities will provide extracurricular activities for patients that need it or are solely living alone and need companionship. Various elderly programs offer services for different elderly needs, i.e., balance and fitness. As you age, you may find that you have a new set of fitness goals you want to achieve, such as improving your balance and flexibility. We're committed to helping older adults stay physically and mentally healthy. (YMCA, 2022) Mercedes-Benz Van: Partnership with a top-of-the-line manufacturer for passenger vans and can even specialize vans for disabled persons would benefit Baycare as they could contract various vehicles for the transportation department. Build your own (Mercedes-Benz Vans, 2022) C1. SOLUTION TYPE

The solution to correct this challenge would be creating an organizational transportation department. The organization can gain additional revenue and add value to its portfolio. C2. EVALUATION Quality and Performance Improvement: The standard process that will improve transportation for healthcare systems, patients, and Baycare Health would be a basic eligibility process. Patients would have to be on Medicare or Medicaid. They don't drive and have to rely on public transportation or wait on others to assist with getting them to their appointments. They must be an established patient of a provider within Baycare and provide proof of annual income. (required once a year). There will be a matrix created to track patient satisfaction. There will be recording devices inside each vehicle that can register any grievances of poor service or even praises for a job well done. There will be satisfaction surveys in each practice office that patients can fill out and put in a locked box for later retrieval and review. Ultimately, results are expected to be on the more excellent side of patient satisfaction, as the transportation department will provide a service that will ease the minds of all who use it and their families. (Syed, Gerber, & Sharp, 2013) Patents and Copyrights will be issued for all technologies created for the Baycare Transport Department, from scheduling to dispatch. The transportation system will be specified to BayCare Medical Group, the Primary Care and Specialty Group of BayCare Health System. All personnel that will be working in the department will go through a significant background check. (Level 2) Training will be given for approximately three weeks, and there will be license checks every three months to review driving history outside work. The transportation department will also improve the quality of healthcare for patients. It will allow them to get to their appointments on time. Patients will obtain the education and knowledge needed to maintain their health outside the primary care office. The relationship

between the primary care provider and the patient will also improve as appointments are kept, and providers can see the patients as scheduled. A "meaningful measure initiative" will be adopted from CMS to measure quality and performance so that improvements can be made where needed. The "Meaningful Measures" Initiative identifies high-priority areas for quality measurement and improvement, intending to improve health outcomes for patients, their families, and measured entities, i.e., clinicians, hospitals, and health plans. Its purpose is to deliver value by empowering people to make informed care decisions while reducing the burden on clinicians and hospitals. (CMS, 2022) Because transportation touches many aspects of a person's life, adequate and reliable transportation services are fundamental to healthy communities. Transportation issues can affect a person's access to healthcare services; These issues may result in missed or delayed healthcare appointments, increased health expenditures, and overall poorer health outcomes. Transportation also can be a vehicle for wellness. Developing affordable and appropriate transportation options, walkable communities, bike lanes, bike-share programs, and other healthy transit options can help boost health. This guide outlines transportation issues and their impact on health and healthcare access. (American Hospital Association, 2022). C3. TYPE OF INNOVATION The transportation department within Baycare Health System will be a disruptive innovation. Other transportation organizations will lose business as patients become eligible to utilize Baycare's transportation versus their previous usage. The qualitative analysis of participants' transportation challenges revealed several themes, including availability, accessibility; safety; physical limitations/health concerns/pain; financial limitations; advanced planning and waiting; and societal attitudes. Table 3 includes challenge themes and illustrative participant quotes. (Remillard, Campbell, Koon, & Rogers, 2022)

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