What additional information do you need to assist in making decisions (remember to create this information if needed)? What are the requirements and implications regarding the Affordable Health Care Act? What would you change? Share the reasons that you chose these changes? How will changing these make a difference? How do you go about implementing these changes? How can these changes be sustained? What barriers might you encounter when making these changes?

The nursing leadership committee of a community based health center is concerned about recent indicators of lower than standard quality patient care from inpatient and outpatient data. The committee wants to have a high patient outcome and recognizes the need to address the following issues:
The scenario
In reviewing the number and type of missed appointments for the past six months, the nurse leader of a community-based outpatient clinic notes that Hispanic patients are 3 times more likely than Caucasian patients to miss their scheduled appointments. The nurse leader confers with the head of the pharmacy that is part of the clinic and discovers that, likewise, Hispanic patients are the least likely of all racial/ethnic groups to get their medication refills.
Choose the major elements/factors/things/processes that can be changed that can affect both patient satisfaction with nursing care, and RN job satisfaction. Design a program/process that increases adherence to medical appointments and medication among Hispanics receiving care from the clinic.
Questions to be answered
What additional information do you need to assist in making decisions (remember to create this information if needed)? What are the requirements and implications regarding the Affordable Health Care Act? What would you change? Share the reasons that you chose these changes? How will changing these make a difference? How do you go about implementing these changes? How can these changes be sustained? What barriers might you encounter when making these changes? What reactions would you anticipate encountering these barriers? How would you overcome the barriers? : What additional information do you need to assist in making decisions (remember to create this information if needed)? What are the potential causes of the disparity? Identify the stakeholders in this community issue and the reasons you chose them. What is your program/process likely to address to decrease the disparity?
Resources:
American Nurses Association (2010). Nursing: Scopes and Standards of Practice (2nd ed.).
Washington, D.C.: American Nurses Association. [ISBN 978-1-5581-02828]
Cherry, B & Jacob, S. (2014). Contemporary nursing: Issues, trends, and management (6th ed.) St. Louis, MO: Mosby: Elsevier. [ISBN: 978-0-323-10109-7]

Rubric
• Application of course content :concepts identified correctly and applied in a logical manner, multiple course concepts used
• Problem solving/decision making: proposed plan/solution is appropriate, sound, logically constructed, capable of being implemented, likely to bring about desired outcomes
• Defense of approach: approach is sufficiently defended as the best or one of the best approaches for addressing issue, approach is supported by appropriate references
• Identification of additional information/data needed to solve problem/resolve issue: Identification of additional information/data needed to solve problem/resolve issue
• Presentation of ideas identified data is appropriate, comprehensive, and evidence-based and presented in a scholarly manner, well-developed succinct paragraphs, grammar, APA format– 6th edition, evidence of proof-readin

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