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Opening a transitional care unit: Cottage Hospital Drogheda

Considering the case of Cottage Hospital Drogheda prepare a new management strategy in relation to opening up of a new transitional care unit at the hospital.

Answer

Introduction 

The cottage hospital idea was established in early 19th century where buildings were constructed having multiple number of beds.  The cottage hospitals are located mostly in and around rural areas for the care and treatment of villagers who were restricted from conditional and special care. The cottage hospital are popular in Scotland, England, and other areas  that deliver healthcare services to the local people. However, in modern times, it has been shaped into community hospitals with wide range of services  of healthcare facilitating individual growth and development. 


The Drogheda Cottage Hospital has been popular for its extensive care services and adhering to the Health Act 2007 in creating transitional care unit for older people within their management structure. The study will provide an extensive understanding of the new strategy, generate an analysis of the health care unit, significance and strength of the strategy, implementation procedure, admission policy to the care unit, and assess the learning gathered from the strategic development.


Background of unit of the organization

The cottage hospital of Drogheda is certified under Health Information and quality Authority  that has supervision and inspection under Chief inspector of Social services inmonitoring new health care service and strategy implemented by the organization. The organization attempts to establish the transitional Care Unit in improving ist management of patients and health welfare. The Transitional Care Unit is a significant art within the cottage hospital that has well trained and qualified nursing faculty (Ballantyne et al. 2018). 


The nursing faculty helps in assisting, treating and provide required services to the different health care unit. The most important responsibility of the TCU is to record and seek the mode of transition of the older patient from the stay in the respective hospital to their home or another care department. The responsibility of the cottage hospital do not rely only on its service and care but the ways it coordinates with the older individual in securing the transition from one place to another for there is a need of change during the patient's course of acute or chronic health condition. 


Aims and objectives of the organization 

The health care hospital has been monitored under the Health Care Act 2007 andaims to follow its amended regulations from time to time. It has shifted its focus to the establishment of transitional care unit benefiting the older section of the society who comes for care and face difficulty in the transition of care services to their shift in home or different care unit. Therefore, the objective is to provide best quality transition care and security under the formulated admission policy. 


  • It aims to assist the older people to maintain safety during their discharge by allowing transfer to short stay of each patient that is enabled to return to respective places in living desired and independent life. The objective is to plan and organize the care setting so that the individual face no difficulty during the period of discharge and his return to home. 
  • To provide best services in accordance to statutory, voluntary and personal services. Providing health care service without disrespecting dignity, community values, independence, privacy and fulfil their needs during their stay recovering from acute illness.
  • To create an environmental friendly and safety environment for staff, nursing faculty and patients. Record the medications, treatment, acute conditions of the patient and provide immediate care.


Introducing a strategy in area of practice

The Cottage hospital attempts to introduce opening a transitional care unit as ist management strategy that will help in building a chamber divided into two units accommodating 23 residents who will be given home-care sot the treatment under Our Lady of Lourdes. The two most important formulation of this strategy is ist admission policy and statement that will give detailed analysis regarding the ways the residents can avail the treatment. 


The transitional care unit provides qualified and experts and nursing faculty who will ensure care for maximum thirty days and will channel safe discharge process (Colligan et al. 2015). The strategy of opening up a transitional care unit will help in preventing any health complications during acute illness and rehospitalizations of chronic illness of the old people (Moir et al. 2015). It i the responsibility to provide safe and comprehensive discharge process coordinated by the nursing unit and acre providers. 


Services and facilities

The Cottage Care Hospital formulates certain striking facilitieswithin the TCU that includes accommodation for twenty three residents that is divided into fourteen in unit two and nine in unite one.  It has introduced the Frail Elderly program that is sponsored by Special Delivery Unitunder the supervision of Department of Health. It will help in recording whether the departments are able to fulfil the needs of patients in different units and that equal care is provided to every individual (Colligan et al. 2015). The hospital provides key personnel in monitoring different needs of the patients like psychiatrist, physiotherapist, Officer for safeguarding, language therapist, chiropodist, dietician and nutritionist. They have maintained expertise at nursing faculty and trains the nurse under the management team towards integration, coordination, care services, individual care and internal assessment of performance. 


The administrative staff  looks after the accounts, salaries, performance, recruitment, resources, assessment of client and provider while the ancillary staff includes health coordinator, fire safety officer, performance development coordinator, human resource developer, risk advisor, nursing development unit, technological department and other occupational departments in meeting the necessary requirement while meeting objectives of the unit and organization  (Ferrante et al. 2015). 


The staff help the visitors and residents in using the lift and stairway for a code is  required to activate and monitor the lift ensuring safety. The hospital has a  car parking system that is in close proximity to the local vicinity.  The person in charge and multidisciplinary team registers the need of each patient and sets goals for them  in accordance to treatment, care and planned discharge (Ferrante et al. 2015). 


Each ward was ist won cleaned showers. Washrooms, and bathrooms that gives them easy access and need not avail the bathroom facilities in another room. Each floor has its own kitchens section that provides snacks besides the meals that allow independence to the patient in living up to their needs. There is a visiting room or waiting room that is well spaced and has comfortable decor in allowing the visitor to sit and wait for their residents. All these facilities and amenities has made it accessible, approachable by the residents providing planned and secured operations and treatment (Colligan et al. 2015). 


Statement of purpose

The statement has been approved by Health Service Executive and under the supervision of person in charge. The statement of the strategy has been approved on May 2017, certified on Health Act 2007 under the regulations of Article 5 (Ballantyne et al. 2018). The conditions of the statement are as follows-

  1. The Cottage Hospital shall act on its operation at all times with effective care and consideration of Health act 2007 
  2. The Hospital need to comply with the amendments made in the Health act from time to time and ensure that the information is delivered to the official and staff equally
  3. The acre unit need to comply with the referral and admission policy in carrying out organised care and welfare of the residents in the designated centres and assure the discharge safety
  4. The authority need to comply with National Standards for Residential Care ensuring the treatment of the older people in compliance with Regulations 2013. 
  5. No person below the age group of 18 shall be allowed in the designated centre and need not exceed the accommodation of twenty three. 


Admission policy 

The centre is responsible solely for its discharging of older people  to their respective home  after the completion of treatment of acute conditions. Under the consent of the patient, he is transferred to the centre who support and organises the patient’s treatment and allow the patient to return to their home. Admission policy is relevant to community services, non-clinical and clinical staff that is regulated under Frail Elderly Project. The admission process to the transitional care unit has certain policies and regulation that are to be followed both the by the care providers and service users. The referral application regarding the patient need to be recommended by the Our Lady of Lourdes hospital assuring hort stay at the centre to determine suitability and acre. the  referral is to be sent to the person in charge of the respective centre. 


The age range of the residents who will be supported with care needs to be above sixty five years that will be ascertained under the Unit of Department of Health. The patients are allowed for the short stay who have the potential to be discharged within the consent charge to thirty days and not more. The policy secure to provide home adaptations for the residents providing them with independence of their own availing to the intensive home-care packages. The policy aims at securing  a shelter for the community people and older people who require and urgent place within the given period of time (Colligan et al. 2015). However, during emergency, when there is a need of extension thirty days, a consent letter needs to be provided by the patient under the consultation of professional team. It is the responsibility of the person in charge and discharge coordinate to ensure that a new expected date is to be consented to the resident in regard to delayed discharge.


Referral, admission and assessment process 

The residents who are admitted for the short stay need to be granted consent under Our Lady of Lourdes and Department of Health following the consent of the family nad Transitional Care provider. Following the consent of OLOL and the criteria of transitional care, eth patient sui admitted in the acre unit under the supervision of multidisciplinary team (Pereira et al. 2015). Each consultant team will undertake an inspection and record the admission details and grant them to the medical officer Dr. John mulroy through clinical discharge letter and details.  It is Dr. Mulroy who is responsible for the prescribed supervision of the acre of patients who are shifted from OLOL and seeks to monitor the day to day management service.


In order to fulfil the criteria of the referral process, it is important to assess the guidelines considering-

  1. Patient has received discharge from our Lady of Lourdes
  2. Patient is above the age of eighteen
  3. Patients is awaiting particular care of treatment, aids and appliances
  4. The patient is aware of the transitional unit procedure, discharge process and exclusion criterias
  5. All required documents of the patient has been signed and countersigned by the care unit authority  


The nursing faculty conduct a pre-admission check up ensuring and recording the needs of the patients and check the faxed pre-admission documents, consent letter and personal documents (Moir et al. 2015). The assessments that are carried out on the patient during pre-admission assessment are waterlow, FRASE, MUST, body weight and height, nutritional and diet requirement, Personal Emergency Evacuation Plan, MMSe, Pain, wound assessment, SSKIN bundle, psychological condition and physio assessments (Wunsch et al. 2015). 


Finally, the patient’s individual requirement list entailing bed type, diet, belongings, medication, money and valuables are kept accountable under the store in charge. The medication that will provided to the patient need to be only ordered from Cottage Pharmacy under the governance of medication policy (Hanlon et al. 2015).


Effectiveness of the strategy addressing Strengths, Weaknesses, Opportunities and Threats 

The advantages of the transitional care programs is that it allow the patients to advocate the bodily changes, medication requirements, mental strength, understand chronic condition and illness and provide home care environment when they are given independence to roam, live, eat and stay under the safety and regulatory acts of the organization (Garlow et al. 2015).  This has brought into major health reform and policies. It helps in providing personalised care under the multidisciplinary care team and reduce the occurrence of risk of getting readmitted. In this case, the care is provided close to homes within the common local setting so that the discharge and return to home will not be difficult. The care unit provides therapy sessions and provides deeper learning to the residents so that they are able to grasp the ways of keeping oneself healthy and safe back at home (Patel et al. 2017). 


The care unit makes the residents comfortable andthe room of the concerned are well equipped where the appliances, belongings and apparts are kept safe and within the reach. The wards are always kept clean and is provided with kitchen corners from where they can have their own breakfast and order meal. The weakness lies in the fact that handling older people is difficult for they are to be handled with care and patiently (Pisani et al. 2015). They are vulnerable to changes, weather, environment and any discrepancy might lead to serious health issue (MacLaren et al. 2015). Therefore, well trained and qualified nursing faculty will help in securing their health condition and provide best care under their suitability. 


Understanding the ways strategy promotes collaboration and meet the expectations of stakeholders 

Establishing a transitional care unit require the consent of all the key personnel, stakeholders and shareholders involved. It is important to seek investments in building a favorable environment and infrastructure that will meet the needs of the residents (Warrick et al. 2015). The environment need to be eco-friendly and the need to include amenities like storage system, parking area, well spaced chambers, visiting room, washroom and more. The admission policy and statement of purpose need to be monitored by the stakeholders so that there can a smooth functioning of operations (Govindaswami, 2017). 


It is the responsibility of the medical officer, service manager to ensure that every personnel from staff, coordinator, nursing faculty to shareholders are allowed to make decisions and is involved in the decision making process and risk assessment (Manente et al. 2017). An unified collaboration with the shareholders, local health communities, qualified nursing group will help in conducting care and services effectively. 


Analysis of the process of implementation of the strategy and its effectiveness 

It has been noted that the process of analysing the implementing the strategies in the upliftment of the transitional unit care will be allowing the patients or the residents he unit to avail the services and the treatment on better note. It has been analysed that the admission policy and the attempt of care that has been adopted the organisation is highly effective due to the number of measures that are to be taken by the unit in order to implement the strategies in the organisation and the statement of purpose that has been given by the organisation. It has been noted that according to the strategies that has been proposed to be included and applied in the given project will be based on different criterions (D’Andreamatteo, Ianni, Lega & Sargiacomo, 2015). 


According to this criterion, the admission of the patient or the individual in the unit will be according to the different requirements that have been provided by the organisation that mainly deals with the short stay of the patients or the individuals in the company. 


It has been noted that the admission policy refers to the fact that the short stay techniques or scheme will be allowing the older people to activate their package of short stay in the unit (Yost et al. 2015). This indicates that they are supposed to be using the package in order to gain treatment form the unit and avail the treatment until there is complete processing of the treatment.  This short stay is mainly for the people who have developed acute illness and has cured the illness, thus, there is the requirement for only giving them the community care for allowing them to be discharged to their respective home with a better health. It has been noted that the admission policy and the statement of purpose can be assessed by the successful completion of the process developed in the unit. It is to be checked that the mentioned criterion for the patient to be admitted in unit is being fulfilled (Grant, 2016). 


It has been noted with the completion of the admission policy, the statement of purpose there will be better monitoring for the patients, and there will more availability of accommodation for the individuals who wants to avail such packages in the unit. After the implementation of the processes in the company, there will be better processing for the patients who are availing the packages in the organisation. 


It has been noted that the organisation will be able to maintain a proper maintenance of the patients who are taking their services. The management of the organization will be more effective as there will be proper regulation given to the clinical staffs of the organisation and the non-clinical staffs of the organisation (DePoy & Gitlin, 2015). The intended project of short stay service will be able to meet the needs the older people as there will be better place of accommodation for them and the organisation will be able to focus on then limited number of individual or patients who will be availing their services.


Analysis of the strategy fulfilling the mission and vision proposed for the organization

            In the organization of Cottage hospital of Drogheda provides the suitable strategy in opening of transitional care unit. This lies at the main management strategy to enhance better services in the healthcare organization. The main aim of this Cottage hospital in Drogheda is to provide suitable care in the transitional care unit among the older people. This has aimed to maintain proper safety from discard at the time of shifting of changes among the place from independent as well as desired life. 


The suitable strategy provides opening of transitional care unit as the planning of management strategy in the Cottage hospital of Drogheda (Patel et al. 2015). The proper strategy helps in filling by mission and vision in the Cottage Hospital of Drogheda. Transitional care services might lies as the certain form of circumstances at the time of admitting older people on the consent areas. There are certain amount of risk that lies among the community that provides suitable form of safety on the problems and carrying out suitable assessment at time of admitting on social admission in the acute services in safety. Transitional care provides suitable continuity on heal care at the time of carrying movements to enhance better form of services among the customers. 


            The transitional care delivers suitable form of techniques to meet the vision and mission statements in the healthcare services. Cottage hospital of Drogheda has been planning to enhance better services in implementing of suitable form of caring among the older people. There are certain areas in the safety of nursing faculty, staff members and patients to provide suitable health care services (Moseley, 2017). The transitional care service is the proper strategy that needs to be focused in such a manner that enables suitable form of acre with the available practitioners in Cottage hospital of Drogheda. 


The mission provides suitable strengthen on health sectors among the community by delivering suitable areas inaccessible, quality healthcare and passionate areas. Vision statements provides suitable healthcare of respective services among the older people on transitional care strategy in the Cottage hospital of Drogheda (Jay & Paul, 2016). The healthcare units has focused in providing of better services by following Healthcare Act 2007 and follows transitional strategy. The transitional strategy provides suitable transactions among the older patients with the suitable rise of risk as the outcomes (Okuno-Jones, Siehoff, Law & Juarez, 2017). 


The errors in communication enhance the involvements in providers and delivers better services for the care service receivers.This strategy has helped the management Cottage hospital of Drogheda to enhance better form of services among the young as well as old people. The proper health care service is provided among the patients at the time of measuring the service. The older people might suffer from the health conditions, in which the transitional strategy provides the better form of care as well as medication (Shanks, 2016). 

Analysis of the learning of strategic development

A number of strategies are developed in order to establish a transitional care unit under Our Lady of Lourdes. In this care unit, the older people above the age of sixty five will be entertained and provide them homely care. The transitional care unit is associated with qualified doctors and nurses who can take excellent care for the patients (Feltner et al. 2014). However, the patients can only be treated for thirty days. The transitional care unit is helpful to provide support the older people who are suffering from chronic illness and acute illness. The care providers and nurses will take care of the discharge process in order to make it safer for the patients.


However, some strategies can be changed in this process in order to provide better services to the patients. The thirty days care policies can be extended because, it is not a very longer term to cure a chronic illness fully and a number of patients cannot be treated effectively (Manville, Klein & Bainbridge, 2014). There can be some patients who are not fully cured in thirty days and changing the environment can enhance the illness again. Some patients cannot get proper care in their home because of no proper idea of the family members, which is also be the reason that those patients are affected by the illness again. 


Therefore, the thirty days timeline can be extended and make it forty-five days for every patients. If any patient cured within lesser time, the care unit can discharge him or her earlier. However, if any patient needs longer time, then the care unit can enhance the timeline. Therefore, the transitional care unit needs to be flexible in this process so that patients can get better care and cure fully (van Sluisveld et al. 2015). However, there can be some other patients who will not get this care because of all the accommodation might be full due to extension of timeline. In this process, the organisation needs to enhance its accommodation and number of employees along with extension of timeline so that maximum number of patients can be treated properly. Therefore, the thirty days timeline can be avoided next time while completing this type of project.


Apart from this, some other strategies can be associated with this project such as an open place for the patients were they could roam around. In order to treat the patients, arrangement if open air can be effective to treat them better. Many patients can feel good while they come to an open environment rather than staying in a room for many days (Allen, Hutchinson, Brown & Livingston, 2014). In this process, the transitional care unit can arrange a park nearby for the patients in which patients can roam or sit with other patients. However, the employees of the care unit need to monitor the patients while they are in park because, if any patient feels unwell, then they can take actions immediately (Kent, 2014). Therefore, the strategy can be associated next time to complete this type of project.


Conclusion

The transitioning acre unit is an important strategy that needs continuous inspection under The health directors ensuring proper functioning. The advancement of the care unit is growing rapidly in different countries providing care services to older people. It is the fastest growing resident fostering the health conditional benefit to vulnerable sections with home care services ensuring safety and suitability. The four major concerns of the care unit towards the older people are drug overdose, medication errors, pressure fall and infections. 


The hospital need to comply with the act and regulations and comply with objectives in laying out care needs and reduce the complexity in the health conditions. The strategy will help in improving resident’s wellbeing, bring in positive responses, improve quality care, and modify transition techniques complying with safety. Considering the competitive and complex external environment, under the compliance of health regulations and policies, the strategy can be effectively implemented ensuring health care development. 



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