QuantitativeCritique: Evaluationof a Collaborative Model for Hospitalized Patient
QuantitativeCritique: Evaluationof a Collaborative Model for Hospitalized Patient
Theresearch question that the study seeks to answer is well-statedbecause it is given in the first paragraph where the author makesclear the aim of the paper. It manages to summarize the ideas thatthe investigation seeks to reply, which in this case, is to determinewhether a care delivery model suggested would improve the outcomesfor the patient (McKay & Wieck, 2014). The question expresses therelationship between the dependent and the independent variableswhere it is clear that the prior is the patient outcome which relieson the type of care administered to the patient. The use of theCaregraph means that these determinants are empirically testable asit is possible to carry out an experiment and gather evidencesupporting the hypotheses. Moreover, the significance of the researchquestion has been identified through explanations that support thestudy based on previous studies. The review critics the article byMcKay and Wieck (2014), which explores how the lack of collaborativecare in health systems is impacting on patient care in the USA. Theresearch introduces the Clinical Integration Model, which works as acombined method for care provision across an interdisciplinary team.The following is a review of the research and its credibility asgiven under the subtitles. The research proves that thecollaborative approach given under CIM in the study is applicable inensuring that patient outcomes are improved, particularly in costreduction for the hospitals. However, the method does not reducedeath rates. The research is relevant to the nursing field since itprovides a new way to ensure improved health care provision andovercome challenges. Covering the suggested gaps in future researchmay help come up with a more effective method and conclusive resultsthat can be applied to the care system. The study is comprehensiveand reliable for use in clinical care.
Thehypothesis outlined in the study is declarative in that it points outthat collaborative care improves patient outcomes in the cases whereit has been utilized before. It clearly shows that the dependent andindependent variables in the study are the patient`s outcomes andcollaborative care since the latter affects the other. The statementof the hypothesis is testable because an experimental design can beset up to prove whether collaborative care has an impact on patientoutcomes. It can be done through a better approach that provides aflexible and combined environment in health care provision.
Reviewof the Literature
Thereview defines the meaning of collaborative approach as used in thestudy using credible research in the field and goes to the extent ofhighlighting both the advantages and gaps that exist in using themodel. Through examining the barriers that exist in the field, thestudy manages to uncover the gaps that exist in ensuring that themethod is effective for patient care. The review reveals that thereis limited literature on how to come up with a collaborativeenvironment which is what this study seeks to find out. On top ofthat, the analysis uses limited research with some sources being old,which may indicate the gap in works on the matter. The studies usedin the review manage to bring out the limitations in the area ofstudy along with its strengths. Though a bit limited, the literaturereview in the paper manages to communicate the need for thisparticular research and the possible gaps it could help fill.
Theframework used for the study is clearly defined and backed up with atheory that is meant to support the author’s claims which make itcredible to use. The model proposed has been in existence for manyyears and it explains how collaboration can be used for patient careand all the aspects that make it applicable in a hospitalenvironment. The Donabedian model used as a framework in the study isconsistent with nursing practice since it manages to examine healthservices and quality of health care, all which are critical topatient’s attention. It is also appropriate in guiding the researchbecause as the research notes, it provides a structure that helpscome up with procedures and effects of care. The variables are welldefined with the caring aspects being defined under the structure ofupkeep, type of processes used, and the expected outcomes, all whichinfluence the eventual results of the study. The frameworkconsequently guides the structure of the collaborative design createdfor this study, which translates to a well-defined care approach forthe patients.
Thedesign used in the study is appropriate since it manages to find away to prove whether using the new collaborative approach whiletreating patients with congestive heart failure was more effectivethan the traditional approach. Through the plan, the differentpopulations have varying outcomes in the measures given, which meansit is appropriate for the study as it answers the relevant questionsconcerning the patient outcome. The design introduced flows with theresearch question because it works to prove the reliability of theproposed collaborative approach as opposed to traditional methods. Italso seeks to fill the gap in the literature review by coming up witha new collaborative approach as proposed by the theoreticalframework. Finally, the design flows along with the hypothesis thatseeks to prove that collaborative care results to better patientoutcomes.
Thestudy uses the experimental design to demonstrate the proposedhypothesis where the population of patients participating is dividedinto two groups with one being the experimental group and the otheras the control. The patients with congestive heart failure fall intotwo categories those who receive care in the traditional setting andthose who use the collaborative approach proposed in the study. Thetraditional care system serves as the control for the design, whilethe collaborative care is the experimental group hence the design isposttest only. The groups were randomly selected where theparticipating facilities either gave the traditional care of thecollaborative care. The threats to this model include mortality wheresince it’s a hospital where there is a likelihood that the subjectsmay leave making the populations unequal which may interfere with theresults. The results from the design are generalizable to the studybecause the patients chosen are similar across the patient populationmeaning they have similar characteristics during admission. Theadvantage of this design is that it the threats to validity caneasily be overcome through manipulation of the population choice.
Thesample features are comprehensively described as those withcongestive heart failure as a single diagnosis gives similarcharacteristics for them all. The measurable factors in theillustrative population can be interfered with as described in thestudy through the treatment criteria to ensure consistency across thetwo samples. The sampling method was random where patients were givendifferent care depending on the hospital they chose. The result wasto come up with four hospitals including A with a population of 339(control) and B with 139 (intervention) with hospital C with 337serving as a comparison for A and D with 148 compared with B (McKay &Wieck, 2014). The research did its best to ensure that there was nobias between the two samples for validity reasons. The rights of theparticipants were guaranteed since the study sought to havepermission from relevant authorities to carry out the study, whichensures that the patient interests are protected.
Datawas collected using a database that tracked patient’s survival,LOS, and the total data cost per hospital in the study. The method ofcollection is not very clearly described and may be lost to thosereading the study. The approach is, however, appropriate for thestudy of all aspects used to compile results are easily tracked onthe database after entry from patient charts care. The study assumesthat data collectors used part of the hospital which means that theyunderstand the concept of the study and the application of thedatabase to patient care (McKay & Wieck, 2014). There is noindication that any external researchers were consulted which meansthat training may have been irrelevant.
Descriptiveand Inferential Statistics
Theresults given include summary statistics of the findings shown intables. It reveals the relationship between the variables of lengthand cost against the hospitals. The hospitals represent the amountsof intervention and controls applied on the population which gives aclear interpretation of the results. The statistics also relateappropriately to the hypothesis by showing the varying resultsbetween the two sample groups. There is the use of variance tounderstand the influence of the variables on the results and how thesample size interfered with the actual results as indicated in thetable. The tables used to summarize the descriptions in numbers asexplained under discussion, which means that the study was coherent(McKay & Wieck, 2014). However, the debate is not clearlyunderstandable, and the variables should have been discussedindependently instead of the approach used.
Theresults of the hypothesis indicate that it is true, especially incost reduction for hospital care where collaborative car suggestedwas used. The results given relate to the theoretical framework sincethe variables identified using it dictate the results and measurepatient outcome depending on care. Based on this, the study concludedthat though other variables were reduced using the collaborative CHFapproach, the death rate was similar across the population. In thatcase, it explains the relationship between the findings and the majoraspects of the study including previous results as given in theliterature. The researcher finds the limitation of the survey,specifically the design, as failure to understand the diffusioncurve. There is also a restriction in biases of the population mainlydue to geographic aspects, homogeneity, and comprehensiveness whichis suggested that it may affect the future application ofcollaborative care. The study suggests that the findings imply theimportance of the integration model in reducing clinical costs,while, at the same time, signifying the need to try the research on adifferent population (McKay & Wieck, 2014). The researcher pointsout to possible future areas of research particularly in furthertesting the model, measuring other variables such as patient and careprovider satisfaction, and the use of CIM in the reduction of errors(McKay & Wieck, 2014). The study concludes that exploring thearea may help achieve better patient care and ensure minimal healthcare challenges in future.
McKay,C., & Wieck, K. L. (2014). Evaluation of a collaborative caremodel for hospitalized patients. NursingEconomics, 32(5),248-268.