NHS FPX 6004 Assessment 2 Policy Need for Policy and Practice Guidelines to Address Benchmark Underperformance

The need for healthcare policies and practice guidelines in healthcare organizations can be understood as it helps in establishing standards that eventually benefit patients, healthcare organizations, and the overall healthcare system. This also helps in improving poor outcomes related to healthcare issues. Similarly to address the benchmark underperformance, it is essential to develop policies and practice guidelines. 

According to the data evaluated from MMC and national benchmarks as described in previous assessments, foot examinations lie at 40% and 42% respectively in the year 2019 and 2020, which according to the national benchmark should be at 84%. Similarly, for HBA1c levels, the tests performed in 2019 and 2020 are 37.3% and 48.3%, correspondingly which is different from the national benchmark as it stays at 79.5% (AHRQ, n.d.).

NHS FPX 6004 Assessment 2 Policy Proposal

These results showed that patients are less involved in their self-management of diabetic states. Diabetes is a disease that has no specific cure, however, the complications can be reduced using appropriate self-management methods. A study to determine the prevalence of poor diabetes self-management in Ethiopian patients concluded that 1 out of 2 diabetic patients lack the behaviors of self-managing their diseases (Habebo et al., 2020). The results from such studies and the Mercy Medical Center’s databases on the reduced number of foot examinations and HBA1c tests advocate the need for the development and implementation of policies using evidence-based strategies as these results are showing poor outcomes on patients’ health, delayed treatment, reduced patients’ satisfaction, increased healthcare costs, and eventually leading to poor quality of life. 

The purpose of this policy proposal is to establish standard methodologies which will help the organization to regularly perform foot examinations and HBA1c tests of diabetic and non-diabetic patients to lower the burden of the disease and improve outcomes by reducing complications. If the problems are not addressed adequately, it may lead to severe complications for the patients which may hinder their lives, cause a financial burden, reduce their well-being, and may cause mortality (Sayeed et al., 2020). 

Summary of Proposed Policy and Guidelines 

In MMC, it is crucial to implement new policies and standard guidelines to improve foot examinations and HBA1c tests for diabetic patients. Mercy Medical Center should develop a policy for the timelines of foot screening among patients with diabetes and diabetic complications. These timelines should be based on the evidence-based recommendations by the International Working Group on Diabetic Foot (IWGDF), which states that foot screening must be done once a year for patients with no incidences of peripheral neuropathy whereas, for patients with peripheral neuropathy, it is recommended to get foot screened every six months.

Moreover, it is recommended that patients with peripheral artery disease, or foot deformity should get it checked every three to six months and those with a leg amputation or pedal ulceration should visit every one to three months (Song & Chambers, 2022). Similarly for the HBA1c, MMC can follow the guidelines suggested by CDC. These standard guidelines define the frequency of HBA1c tests accordingly: 

1. A baseline HBA1c test is required for adults over 45 years of age, or if they are underage but overweight and have any risk factors related to diabetes. 
2. Repeating the test every 3 years is required for adults over 45 years with risk factors.
3. Repeat the test every 1 to 2 years if you fall in the range of prediabetes. 
4.  For patients already diagnosed with diabetes, tests should be performed at least twice a year (CDC, 2022). 

NHS FPX 6004 Assessment 2 Policy Proposal

Some of the environmental factors that have potential effects on the recommended guidelines are tax exemption and compliance, staffing issues, lack of finances and logistics, and data breaches. Mercy Medical Center may require to fulfill the criteria of the Patient Protection and Affordable Care Act to make their care exempted from taxes (Crowley & Bornstein, 2019). This tax-tax exemption will help them to ensure that the number of foot examinations and HBA1c tests is increased according to the proposed policies.

Moreover, adequate staffing and resources (finances and logistics) will help in enhancing patient education and performing the tests as per the practice guidelines which will ensure effective performance against national benchmarks. Data breaching is one of the most important aspects that MMC needs to focus on related to the tests performed. Showing HIPAA (protection of patient’s informat