1 2 Care Management Kimberly Boynton Grand Canyon University HCA-699- Evidence Based Research Project Edward Paulch 10/13/2021 Care Management Care management is a term that refers to the activities carried out to improve patient care and reduce the need for medical services by enhancing care coordination and helping patients and caregivers to manage their healthcare conditions effectively. Care management utilizes several integrated programs which extend beyond current clinical care. Care management consists of several healthcare professionals, such as nurses, social workers, and patent educators. These healthcare management professionals work collaboratively to create a health care plan that will help meet the specific needs. Care management services include patient education, medication management, managing symptoms, and preventative testing. This essay aims to formulate a PICOT question associated with care management, describing the problem's background and identifying the key stakeholders. Background of the Problem The problem that is aimed to be solved in care management is high rehospitalization rates due to poor care management among adults. Older adults are at risk have several complex medical and social needs that are fatal and can result in high increased mortality rates among older adults if care management for these adults is not efficient and effective. These medical conditions and social needs result in rapid hospitalization of older adults, which can be prevented through care management ((Wideman, 2012). Although the united states government has put in place several regulations and policies to ensure that the care management offered to older people is the best, several challenges have made it impossible to meet goals that have been put in place. One of the challenges includes a lack of guidelines to address care transitions between the hospital and the nursing home. Standardized disease management approaches should be introduced in geriatric care management to help lower hospitalization rates of the intended population. One of the ways to improve the quality of geriatric care management is through the use of pay for performance incentives. Pay for performance incentives are offered to healthcare providers if they meet specific performance results instead of their work. This incentive will motivate the healthcare team responsible for geriatric care management to improve the quality of care, efficiency, and the overall care they will be providing for the older adults, resulting in reduced hospitalization rates. Stakeholders Several stakeholders are involved in the care management of older persons. These stakeholders are older adults, healthcare providers, the united states government, payers and policymakers, and the Medicare and Medicaid Services center. These stakeholders need to work together to ensure the successful implementation of the proposed solution. Implementing the proposed solution will help reduce t ...

1. 1
2
Care Management
Kimberly Boynton
Grand Canyon University
HCA-699- Evidence Based Research Project
Edward Paulch
10/13/2021
Care Management
Care management is a term that refers to the activities carried
out to improve patient care and reduce the need for medical
services by enhancing care coordination and helping patients
and caregivers to manage their healthcare conditions
effectively. Care management utilizes several integrated
programs which extend beyond current clinical care. Care
management consists of several healthcare professionals, such
as nurses, social workers, and patent educators. These
healthcare management professionals work collaboratively to
create a health care plan that will help meet the specific needs.
Care management services include patient education,
medication management, managing symptoms, and preventative
testing. This essay aims to formulate a PICOT question
associated with care management, describing the problem's
background and identifying the key stakeholders.
Background of the Problem
The problem that is aimed to be solved in care management is
high rehospitalization rates due to poor care management among
adults. Older adults are at risk have several complex medical
and social needs that are fatal and can result in high increased
mortality rates among older adults if care management for these
adults is not efficient and effective. These medical conditions

2. and social needs result in rapid hospitalization of older adults,
which can be prevented through care management ((Wideman,
2012). Although the united states government has put in place
several regulations and policies to ensure that the care
management offered to older people is the best, several
challenges have made it impossible to meet goals that have been
put in place. One of the challenges includes a lack of guidelines
to address care transitions between the hospital and the nursing
home. Standardized disease management approaches should be
introduced in geriatric care management to help lower
hospitalization rates of the intended population. One of the
ways to improve the quality of geriatric care management is
through the use of pay for performance incentives. Pay for
performance incentives are offered to healthcare providers if
they meet specific performance results instead of their work.
This incentive will motivate the healthcare team responsible for
geriatric care management to improve the quality of care,
efficiency, and the overall care they will be providing for the
older adults, resulting in reduced hospitalization rates.
Stakeholders
Several stakeholders are involved in the care management of
older persons. These stakeholders are older adults, healthcare
providers, the united states government, payers and
policymakers, and the Medicare and Medicaid Services center.
These stakeholders need to work together to ensure the
successful implementation of the proposed solution.
Implementing the proposed solution will help reduce the
rehospitalization rates of older adults by improving care
management which will benefit the older population.
PICOT Question
In older patients (P), what is the effect of pay for performance
incentives for nurses (I) on improving care management and
reducing rehospitalization rates (O) compared with the use of
social support (C) within six months?
Purpose and Project Objective
This project aims to improve the quality of geriatric care

3. management, which will reduce rehospitalization rates among
patients. The study's objectives are: to improve the quality of
geriatric care management within six months and reduce the
rehospitalization rates of older adults within six months.
Rationale
It is important to address the issue of care management in older
adults for several reasons. The first reason is that it will help
reduce the mortality rates of older people, and the second
reason is that it will help reduce rehospitalization rates (Vogeli
et al., 2007). It is also important to address this issue to ensure
quality and improved care for older adults.
Initial Reference List
Golden, A. G., Tewary, S., Dang, S., & Roos, B. A. (2010).
Care management's challenges and opportunities to reduce the
rapid rehospitalization of frail community-dwelling older
adults. The Gerontologist, 50(4), 451-458.
Donelan, K., Chang, Y., Berrett-Abebe, J., Spetz, J., Auerbach,
D. I., Norman, L., & Buerhaus, P. I. (2019). Care management
for older adults: The roles of nurses, social workers, and
physicians. Health Affairs, 38(6), 941-949.
Bodenheimer, T., & Berry-Millett, R. (2009). Care management
of patients with complex health care needs. Policy, 1(6).
Moyle, W., Olorenshaw, R., Wallis, M., & Borbasi, S. (2008).
Best practice for the management of older people with dementia
in the acute care setting: a review of the literature. International
journal of older people nursing, 3(2), 121-130.
References
Vogeli, C., Shields, A. E., Lee, T. A., Gibson, T. B., Marder,
W. D., Weiss, K. B., & Blumenthal, D. (2007). Multiple chronic

4. conditions: prevalence, health consequences, and implications
for quality, care management, and costs. Journal of general
internal medicine, 22(3), 391-395.
Wideman, M. (2012). Geriatric care management: role, need,
and benefits. Home Healthcare Now, 30(9), 553-559.
Appendix
HCA-699
PICOT Question Template
Section 1: In this section, provide one word to describe each
section of your proposed PICOT question.
P
Population
Older adults
I
Intervention
Pay for performance
C

5. Comparison
Social support
O
Outcome
Improve care management and reduce rehospitalization rates
T
Timeline
6 months
Section 2: Write your PICOT question below using the words
listed above.
PICOT
Section 3: Use your PICOT to develop a formalized statement.
Use the examples below to help formulate the statement.
In ___older patients____ (P), what is the effect of _pay for
performance incentives for nurses______ (I) on __improving
care management and reducing hospital reshoplizaton
rates____(O) compared with _the use social support ______(C)
within _six months_______ (T)?
Are ____ (P) who have _______ (I) at ___
(Increased/decreased) risk for/of_______ (O) compared with
______ (P) with/without ______ (C) over _____ (T)?
For ________ (P) does the use of ______ (I) reduce the future
risk of _hospitalization _______ (O) compared with _________
(C)?
Does __________ (I) influence ________ (O) in (subject) who
have _______ (P) over ______ (T)?
PICOT Template
Creswell, J. W. (2003). Research design: Qualitative,

6. quantitative, and mixed methods approach. Sage Publications.
Melnyk B., & Fineout-Overholt E. (2010). Evidence-based
practice in nursing & healthcare. Lippincott Williams & Wilkins
HCA-699
Literature Review: Table of Evidence
Name:
Problem Statement:
Criteria
Article 1
Article 2
Article 3
Article 4
Article 5
Author, Journal (Peer-Reviewed), and Permalink or Working
Link to Access Article

7. Article Title and Year Published
Research Questions (Qualitative)/Hypothesis (Quantitative), and
Purposes/Aim of Study
Design (Quantitative, Qualitative, or Other)
Setting/Sample
Methods: Intervention/Instruments

8. Analysis
Key Findings
Recommendations
Explanation of How the Article Supports Your Identified
Barrier or Issue in Health Care
Criteria
Article 1
Article 2
Article 3
Article 4
Article 5

9. Author, Journal (Peer-Reviewed), and Permalink or Working
Link to Access Article
Article Title and Year Published
Research Questions (Qualitative)/Hypothesis (Quantitative), and
Purposes/Aim of Study
Design (Quantitative, Qualitative, or Other)
Setting/Sample

10. Methods: Intervention/Instruments
Analysis
Key Findings
Recommendations
Explanation of How the Article Supports Your Identified
Barrier or Issue in Health Care

11. Criteria
Article 1
Article 2
Article 3
Article 4
Article 5
Author, Journal (Peer-Reviewed), and Permalink or Working
Link to Access Article
Article Title and Year Published
Research Questions (Qualitative)/Hypothesis (Quantitative), and
Purposes/Aim of Study
Design (Quantitative, Qualitative, or Other)

12. Setting/Sample
Methods: Intervention/Instruments
Analysis
Key Findings
Recommendations

13. Explanation of How the Article Supports Your Identified
Barrier or Issue in Health Care
© 2021. Grand Canyon University. All Rights Reserved.
2
LITERATURE REVIEW
The purpose of this assignment is to prove that the research
support for the proposed solution of Care Management is
sufficient, compelling, relevant, and from peer-reviewed
professional journal articles. You will gather a minimum of 12
current, peer-reviewed journal articles based on your topic.
They must be published within the last 5 years. Complete the
attached summary template, "Literature Review: Table of
Evidence," for each article. Using a summary table allows you
to be more concise in your narrative description. Only research
studies you are using to support your intervention should be
summarized in this table. PLEASE USE THE ATATCHED
PART A PROBLEM DESCRIPTION & PICOT FOR YOUR
REFERENCE. (THE PICOT ISAT THE END OF THE
PROBLEM DESCRIPTION)
While APA style is not required, solid academic writing is

14. expected, and documentation of sources should be presented
using APA formatting guidelines.