The instructor will assign each student a capstone project paper draft of a peer to critique. The draft paper should be at least eight pages (2,000 to 2,700 words).Review the draft capstone project paper assigned to you (from title page to reference page). Critique the draft by analyzing the content and providing extensive comments evaluating scholarly discourse (grammar, theme development, transition, clarity, and appropriateness of content). Communicate your feedback in an encouraging, professional manner. All edits should be made on the actual document using track changes.Feedback and critique on the draft paper should address the following:Does the writer make the barrier or issue clear in the introduction?Does the writer’s course of action for addressing the barrier or issue follow the logic model?Does the writer meet the criteria for each section as presented in the assignment?Analyze the writer’s anticipated effects of a change initiative upon an organization.Analyze the writer’s potential issues related to sustainability.Does the writer use professional health care terminology appropriately and correctly?Does the paper flow smoothly? Does the paper follow a clear organizational pattern? Do the body paragraphs occur in a logical order? If not, suggest which paragraphs should be moved, where they should be placed, and why.Does the writer provide enough information from the research and supporting articles to clearly support the change project for a nursing intervention?Do you notice any errors in grammar, mechanics, punctuation, or formatting?What advice can you give this writer for each section of the paper and to improve the draft overall (suggestions for improvement, outside resources/sources)?Your feedback will help your fellow student identify possible strengths, weaknesses, and basic errors. Be thorough, keeping in mind that the suggestions you provide will help your classmate make the changes necessary to complete a more successful paper.
Peer Review of Capstone Project: Health Disparities Faced by Rural Populations
Lindsey Selden
College of Nursing and Health Care Professions, Grand Canyon University
HCA-494
Professor Ryan Washington
10 July 2022
Introduction
Health disparities are faced by rural populations across the United States resulting in a
higher rate of negative health outcomes. About 15% of the entire US population lives in rural
locations (CDC, 2017).
The Issue
Rural populations around the United States face more and more barriers to health care each
year. They are more likely to suffer or die from strokes, heart disease, cancer, chronic lower
respiratory disease, and unintentional injury as well as suffer from mental, developmental, and
behavioral disorders (CDC, 2017). The issues they face typically revolve around the
accessibility to and the affordability of health care services.
The Solution
The solution to this prominent issue targets and addresses four current problem areas: the
health care professional (HCP) shortages in rural areas, the affordability of services and
insurance coverage, broadband Internet access, and the range of transportation options.
Sustainable programs must be implemented to fix these series of issues. Modern day
technology and systems continues to serve as a viable resource and solution, however, there
are key components that need to be present in order for it to do so and there must be clear
boundaries set in place to negate other issues from occurring as unintended consequences. This
solution also focuses on how the health care perspective must shift from a reactive approach to a
proactive approach. Health clinics and the health care professionals within rural facilities will be
the first line of defense in preventing prominent and rapidly progressive diseases in rural areas.
The ultimate goal is to combine the efforts of various stakeholders across multiple fields to
make health care services more accessible for rural populations to improve the probability of
positive health outcomes.
Resources
Determining the resources necessary to implement a change plan is a key part of
uncovering whether or not a projects goals can be fulfilled. If a certain resource is identified
as being essential to produce the desired outcome, then it must be available and present in and
throughout the process. If it is not obtainable, aspects of a change plan need to be reviewed and
revised. In this example, the resolution to improve rural health care and health outcomes
requires a certain budget that invests into the communications infrastructure within rural health
systems. In addition, other resources such as electronics to host telehealth communications,
technicians to maintain and fix the technology systems and items, experts or leaders who will
train staff on how to use those communication tools are also required, vehicles for
transportation, and updated rural population data.
Stakeholders
After assessing resources, stakeholders will be actively engaged in the change process
in order to increase its capability to be successful. Those stakeholders include health care
professionals, providers, patients, insurance companies, internet and cable companies, and
local and state governments (potentially the federal government as well) (County Health
Rankings & Roadmaps & University of Wisconsin Population Health Institute, 2016).
Partnerships between providers and transportation companies will be established and new plan
agreements will be developed between payers and providers. The most valuable information
will come from both the rural patients and rural providers. They will provide the best insight
into the various elements outside of health care that influence their health decisions and
lifestyle choices. Looking at stakeholders holistically, not only considers outside factors, but
also allows a more well-rounded and viable solution to be created that is just as unique as the
problem itself.
Stakeholder Management
Stakeholders play a vital role in the success of any change plan and must be considered
throughout the entire process (Simonarson, 2017). Like in any change process, both types of
stakeholders, both internal and external, need to be considered. They each have different needs,
desires, and concerns related to plans of change (Huemann, et al., 2016). Doing this will give
the why behind the decision to reconstruct an already-established system.
Implementation Plan: Overview
With any plan, comes a need for strategies to reach short- and long-term goals. The four
areas of focus of this plan all require different strategies. HCP shortages in rural locations
require direct action on HCP educational curriculums, training practices, and incentives
programs. Examples of how rural information can be added to already-constructed syllabi will
be a good place to start when introducing the idea to internal stakeholders. In this case, the
internal stakeholders are students, educators, support staff, and board members. On the other
hand, the external stakeholders in this example are government bodies at the local, state, and
federal levels, accreditors, suppliers, regulatory agencies, and so on. They will be presented
with evidence-based data that draws the connection between educating HCPs on rural
populations and achieving more desirable outcomes for rural populations. The other three plans
involve: lobbying for representatives that support the creation of state and federal laws that
require private health insurers to cover telemedicine coverage (Shachar, et al., 2020) as well as
working with stakeholders to create transportation routes and company partnerships, draft
estimates for fund requirements that support those programs for an extended period of time,
and constructing detailed budgets required to build a wider range of broadband Internet
communications infrastructure in rural locations (Marre, 2020).
Implementation Plan: Communication Strategies
With any plan, communication means must be part of a strategy and change plan. This
plan will use the foundation of transparency by producing both the pros and cons of each
possibility and decision. Therefore, both internal and external stakeholders preferred
communication preferences must be considered as well as the current barriers that exist in
those communication streams (Shakeri, et al., 2020). For example, a study conducted by
Coombs, et al. discussed the barriers that exist between providers and patients in the rural areas
around the US. From the data they collected, the researchers uncovered several items: there is
friction between the identities of rural patients and health systems that are nearest to them, a
need for cultural awareness when creating treatment plans, fragmented communication
between providers and patients as well as between providers and other providers, resource and
time restrictions harm rural health systems the most, and profits are more of a priority than
breaking down accessibility barriers in the US currently (Combs, et al., 2022). However, there
are tools that will be put into place to reduce those barriers in the future. It requires that there
be shared values, intentions, and goals between providers serving in those areas. That will be
taught in the beginning stages of their professional careers, in school. Educational institutions
should also expand their current curriculum on rural communities and their needs
Timeline
This timeline is designed to show how long each of the short-term goals is expected to
take in the change plan to improve health outcomes of rural populations.
I.
III.
Explain organizational
resources that will help
implement change plan
and maintain it.
Examples:
a. Physical
communication
electronics
b. Finances
c. Stakeholders
d. Experts & leaders
in telehealth
communications
4 Weeks
Identify
communication
strategies to internal
and external
stakeholders to
facilitate a change
plan.
a. Transparency
b. Presents both pros
and potential
cons/barriers
c. Share values,
intentions, and
goals (as well as
any alterations)
2 Weeks
II.
Identify the
stakeholders needed to
support the
implementation of the
proposed plan.
6 Weeks
IV.
Determine the type of
impact this change plan
will have on the
organization and its
stakeholders.
a. Finances
b. Ways of practice
c. Access
d. Regulations
10 Weeks
V.
Discuss the expected
outcomes for you
initiating your
proposal.
a. Improved access to
telehealth
b. Affordability of
both basic and
specialty services
c. Increased
transportation
options
d. Wider access to
broadband Internet
12 Weeks
VII.
VI.
Identify potential
barriers to
implementing the
change plan.
a. Long held distrust
in P-P relationship
b. Disinterest in
changes
c. Response to
financial
investment
requirements of
changes
8 Weeks
Identify steps for
overcoming the
potential barriers.
a. Research
b. Discuss
c. Plan
4 Weeks
Evaluation Plan
The evaluation method that will be implemented to the invention plan that aims to
improve health outcomes of rural populations is the Kaizen methodology. It will be used to
determine the effectiveness of the changes being made by the plan. The word Kaizen is of
Japanese origin that means good change. An objective of this methodology is to
incrementally implement small changes that add up to larger changes over a longer period of
time (PHAB, 2020). It also aims to limit waste by making changes that best suit the needs and
desires of a certain group. Although the Kaizen methodology is not highly used in health care
yet, it does present some strengths to the field (Mazzocato, et al., 2016).
Evaluation: Resources
Populations within rural areas tend to have slower progression and longer adjustment
periods; therefore, the Kaizen principles are the most suitable for rural populations.
Additionally, it also focuses on sustained continual improvement in certain areas of a project
(EPA, 2021). During the evaluation process of an improvement initiative, Kaizen methodology
limits resource waste by involving key stakeholders, such as individuals living in rural
communities. It is a revolving process that requires feedback from those same groups in order
to determine if the improvement plan was successful, partially successful, or a failure. Then it
uses their comments and suggestions to redesign entire plans or areas of plans (Mazzocato, et
al., 2016). Moreover, a budget to collect the feedback as well as personnel to assess the data
will also need to be prepared.
Evaluation: Projected Outcomes
Furthermore, this specific methodology was chosen for a few reasons. This particular
change plan focuses on improving the health outcomes of rural populations. The Kaizen
principles aligned with the way in which the plan intends to implement most of the changes,
which is in a slow format, due to the typical type of life practices of people that live in rural
communities. Additionally, it is a type of evaluation that involves feedback from key
stakeholders, in this case, individuals who live in rural areas. For example, one study by
Hamel, et al., analyzed what key issues rural people expressed most concern for. The two top
results where jobs/employment and drug abuse. Cost/availability of healthcare ranked lower on
the list (2017). However, one of the aspects of the change plan will be to expand broadband
internet access to more rural communities which will add more jobs, lower unemployment
rates, and opportunities for more businesses to flourish, in addition to increase health care
accessibility (Marre, 2020). Knowing this, the change plan will be introduced in a way that
will entice rural communities to adopt solutions that will also help their other higher ranked
areas of concern as well. Overall, it is projected that the most success changes will be those
that directly correlate and algin with the needs and requirements of key stakeholders
throughout the whole process.
Dissemination Plan: Who, What, Where, How, and When
Evidently, strategic plans must be shaped upon a sturdy foundation that also helps direct
the entirety of a plan. All plans require evaluations throughout the process in order to create
successful results. Alongside that, the who, what, where, how, and when must all be
discussed prior to the implementation of interventions. In the case of the strategic plan that has
the goal of improving rural population health outcomes, the plan is to follow a timeline that has
steps that target individuals who live in rural locations by addressing the current health care
professional shortages, affordability and insurance coverage of telehealth services, accessibili ty
to broadband Internet access, and the range of transportation options within rural areas.
Dissemination Plan: External and Internal Project
Therefore, there are several methods that will be used to share important information
both externally and internally. The external project that will disseminate the findings and other
crucial details will use local newspapers, radio stations, health care locations, and highertraffic public locations, via bulletin boards, flyers, pamphlets, infomercials. On the other hand,
information will be spread internally primarily by emails, video conferencing, and in-person
meetings when possible (Rural Health Information Hub, 2011).
Potential Barriers
Potential barriers include distrust in patient-provider relationships, negative responses to
financial requirements from larger and more influential stakeholders, and disinterest from
individuals due to focus on more important issues to them. In order to overcome those barriers,
they will need to be examined. For example, rural governments may be unwilling to invest in
broadband Internet due to the misconception that it will only increase access to health care. As
shown by many studies, including the article by Alexander Marre, broadband access is actually
linked to lower unemployment rates, increased job growth, and higher rates of business
creation (2020).
Conclusion
By deploying these strategies and making these changes, the needs of populations will be
more well-known by HCPs, more telehealth services will be more financially accessible,
broadband internet will be more accessible and affordable, and there will be a wider range of
transportation service options to rural populations. The objectives are to increase positive and
more desirable health outcomes of rural communities by expanding access to and increasing
the utilization of both basic and specialty health services.
References
Centers for Disease Control and Prevention. (2017, Aug 02). About rural health. U.S.
Department of Health & Human Services. https://www.cdc.gov/ruralhealth/about.html
Coombs, N. C., Campbell, D. G., & Caringi, J. (2022, Apr 02). A qualitative study of rural
healthcare providers’ views of social, cultural, and programmatic barriers to healthcare
access. BMC health services research, 22(1), 438. https://doi.org/10.1186/s12913-02207829-2
County Health Rankings & Roadmaps & University of Wisconsin Population Health Institute.
(2016, Jul). What works?: Strategies to improve rural health. County Health Rankings
& Roadmaps. https://www.countyhealthrankings.org/reports/what-works-strategiesimprove-rural-health
EPA. (2021, Oct 19). Lean thinking and methods Kaizen. United States Environmental
Protection Agency. https://www.epa.gov/sustainability/lean-thinking-and-methodskaizen#:~:text=Kaizen%2C%20or%20rapid%20improvement%20processes,and%20pro
cesses%20of%20an%20organization.
Hamel, L., Wu, B., & Brodie, M. (2017, Jul 16). The health care views and experiences of rural
Americans: Findings from the Kaiser Family Foundation/ Washington Post survey of
rural America. Kaiser Family Foundation. https://www.kff.org/report-section/the-healthcare-views-and-experiences-of-rural-americans-findings/
Huemann, M., Eskerod, P., & Ringhofer, C. (2016). Rethink! Project stakeholder management.
Project Management Institute.
Kannarkat, J. T., Krampe, N., Hughes, L. S., & Silimperi, D. (2022, Feb 23). Solving rural US
health care challenges with frugal innovation: Low-costs, high returns. Health Affairs.
https://doi.org/10.1377/forefront.20220222.972908
Kaplan, B. (2021). Access, equity, and neutral space: telehealth beyond the pandemic. The
Annals of Family Medicine, 19(1), 75-78.
Marre, A. (2020, Dec). Bringing broadband to rural America. Federal Reserve Bank of
Richmond, 8(1). https://www.richmondfed.org//media/RichmondFedOrg/publications/community_development/community_scope/2020
/community_scope_2020_no1.pdf
Mazzocato, P., Stenfors-Hayes, T., von Thiele Schwarz, U., Hasson, H., & Nyström, M. E.
(2016). Kaizen practice in healthcare: a qualitative analysis of hospital employees’
suggestions for improvement. BMJ open, 6(7), e012256.
https://doi.org/10.1136/bmjopen-2016-012256
PHAB. (2020, Feb). Quality improvement methodologies: Determining the best approach for
incorporating QI into your agencys practice. PHABs Evaluation and Quality
Improvement Committee & Grace Gorenflo. https://phaboard.org/wpcontent/uploads/ComparisonFrameworkFeb2020.pdf
Rural Health Information Hub. (2011, Jan). Methods of dissemination. RHIhub.
https://www.ruralhealthinfo.org/toolkits/rural-toolkit/6/dissemination-methods
Simonarson, M. (2017, Sept 06). How to set a company vision and get buy-in from
stakeholders. Forbes. https://www.forbes.com/sites/theyec/2017/09/06/how-to-set-acompany-vision-and-get-buy-in-from-stakeholders/?sh=43e0b32150ab
Shachar, C., Engel, J., & Elwyn, G. (2020, May 18). Implications for telehealth in a post
pandemic future: Regulatory and privacy issues. JAMA. 2020;323(23):2375-2376.
https://doi.org/10.1001/jama.2020.7943
Shakeri, H., & Khalilzadeh, M. (2020). Analysis of factors affecting project communications
with a hybrid DEMATEL-ISM approach (A case study in Iran). Heliyon, 6(8), e04430.
https://doi.org/10.1016/j.heliyon.2020.e04430
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