Response to classmate week 5 | DDHA 8246 – Advanced Application of Practice-based Research in Health | Walden University

 Respond to at least two of your colleagues’ postings offering suggestions of other theoretical or conceptual frameworks that may be appropriate for his or her Doctoral Study topic. 

this is my classmate work that need critique


The Doctoral Study topic I have chosen can be viewed as a social/research problem and a healthcare administration problem across many healthcare organizations in the country.  Effective communication is a vital element in all areas of health care and can enhance the patient experience and increase patient satisfaction scores, which in turn, can increase a hospital’s bottom line.   The issue that prompted me to search the literature is that communication failures between nurses, doctors, and patients negatively affect a patient’s perception of care.  The specific research problem that will be addressed through my study is that communication failures between nurses, doctors, and patients decrease patient satisfaction scores (HCAHPS) and impact a hospital’s bottom line.  However, despite the fact that academics have looked into this topic, there is little or no literature on the influence communication has on the patient experience, patient satisfaction ratings (HCAHPS), and the bottom line of a hospital (Davidson et al., 2017).

However, it is well-known that hospital patient satisfaction ratings, as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), have played a significant role in hospital payment via the Hospital Value-Based Purchasing Program. A hospital’s HCAHPS ratings will determine how much money it will get in reimbursements, and the better the score a hospital receives, the greater the reimbursement. Reduced patient satisfaction and reduced Medicare funding are two ways that poor HCAHPS ratings have an influence on a hospital’s bottom line. First, they harm the hospital’s reputation among customers, and second, they reduce Medicare funding (Detwiler & Natalie, 2020).

The Swanson Caring Theory (SCT), the Carolina Care Model (CCM), and the Caring Attribute Diagnostic Model (CADM) will be used to support my study. 

In addition to serving as the basis for hundreds of research investigations, the SCT theoretical framework also serves as a theoretical underpinning for the nursing care given at clinical facilities across the globe. Swanson’s Caring Theory describes five caring processes: knowing, being with, acting for, enabling, and preserving belief in the person you are caring for (McKelvey, 2018). The SCT was made a reality at the University of North Carolina Health System with the creation of the CCM (Ray & Stargardt, 2020).

CCM is a program that supports particular behavioral interventions that combine nursing behaviors with caring processes in order to improve the patient’s overall experience (Ray & Stargardt, 2020). I also collaborate closely with Deb Stargardt, one of the CCM’s original creators, and help with the teaching of CCM and the SCT across the Johnston UNC Healthcare system. Using the SCT framework as a guide, CCM connects particular interventions such as the moment of caring, hourly rounds, no-passing zone, words and methods of communication that are effective, and the blameless apology with SCT processes such as knowing, being with, acting for, and enabling. Staff attentiveness to patients’ needs and nurses’ and physicians’ communication are both indicative of SCT processes of knowing and Being With. When asked about communication with nurses and communication with physicians, patients’ responses reflect their opinions of attentive listening, easily intelligible explanations and polite, respectful interactions with their healthcare providers. A growing body of research suggests that empathy and trust are critical in the commencement of supportive, interpersonal communications when they are lacking (Ray & Stargardt, 2020).

HCAHPS items and global questions may be examined via the lens of SCT using the CADM, which offers specific actions that boost perceptions of care processes, caring qualities, and patient well-being. Each HCAHPS question (item) and domain is mapped to one of the five SCT processes in the diagnostic model. As a result of this alignment, the CADM grows into SCT subdimensions of practical behaviors that aid perceptions of SCT qualities such as compassion, competence, and well-being. The top box scores from the HCAHPS domains are averaged to provide a composite score for each characteristic in order to help prioritize improvement actions (Ray & Stargardt, 2020).

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