Nursing: Consultative Change Recommendation

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Table of Contents

Purpose of Consultation and Overview of the Consultation Process
Organizational Analysis
Primary Needs of Organization’s Population
Nurse Leader Interview Summary
Conclusion
References

It goes without saying that changes in the performance of health care providers and in the process of health care delivery are eventually required to improve the general quality of the public health care system affected by unpredictable circumstances. At the same time, local medical facilities aim to implement changes according to their clients’ needs. In order to evaluate the necessity of specific changes, consultations with health care practitioners are constantly required.

Purpose of Consultation and Overview of the Consultation Process

This work implies the analysis of the interview taken from a public health nurse (care coordinator) of the Hennepin County Mental Health Center to evaluate the general state of this medical facility and identify the necessity of changes.

Organizational Analysis

The Hennepin County Mental Health Center (HCMHC) is a medical organization that provides high-quality and low-cost mental health services for people in Hennepin County, Minnesota. It serves adults with serious mental diseases and related substance use disorders. HCMHC serves children and adolescents with severe emotional disturbance who have been neglected, abused, or court-ordered for evaluation, as well (“Clinics and services,” n.d.). The center is licensed as a DHS Rule 29 Community Mental Health Center by the State of Minnesota (“Clinics and services,” n.d.). In general, in Hennepin County, there are four health departments that serve a population of 1,224,763 people in an area of 554 square miles (CountyOffice.org, n.d.). Every health department is designed for 306,190 people within the territory of 138 square miles (CountyOffice.org, n.d.).

Located in the Nicollet Exchange Building, 1801 Nicollet Avenue, Minneapolis 55403, HCMHC provides a comprehensive and client-oriented treatment that aims to promote patients’ self-efficacy, general wellness and recovery, and life enhancement. Its experienced team of qualified health care providers understands recovery as an individual process and personalizes treatment according to a person’s needs. Professionals develop a plan of treatment and care for every client with the focus of his or her person-specific goals and initiate the participation of the patient’s support system or other service providers if necessary (“Clinics and services,” n.d.).

As a county-supported facility, HCMHC provides medical help for the residents of Hennepin county or individuals for whom it has financial responsibility. Despite the fact that the center prioritizes patients referred by Hennepin County Departments, it helps people who may encounter particular barriers to care, as well. In general, HCMHC is a safety net provider that primarily serves citizens without commercial insurance or citizens who are underinsured or uninsured (“Clinics and services,” n.d.). Moreover, the center welcomes all clients who are regarded its flexible service model as beneficial. In order to be accessible and completely responsible for patients’ needs, HCMHC offers walk-in visits as well as scheduled appointments.

In order to provide high-quality mental health care, the center uses a multidisciplinary approach and offers a wide range of medical services that include the following categories:

Assessments and evaluations (Psychological and psychiatric evaluations, combined (parenting and psychological evaluations, diagnostic assessments);
Therapy and education (Individual and group therapy, consultation, psycho-education, general health and wellness education);
Medication services (Nurse line, medication management, genomic testing, on-site pharmacist);
Whole-person care (The delivery of primary mental health care to adult patients, outreach to persons experiencing homelessness, treatment for co-occurring substance use and mental disorders, resource assistance and care coordination, collaboration with service providers and community partners, the creation of Access employment program with Rise) (“Clinics and services,” n.d.).

Primary Needs of Organization’s Population

It goes without saying that Hennepin County Public Health defines the health data collection, review, and analysis as its highly significant function (“Public health data,” n.d.). It uses the Community Health Assessment in order to monitor the health condition of adults and children of Hennepin County. This tool serves as a specific recourse “for an ongoing conversation about policies and programs to enhance health in the county” (“Public health data,” n.d., para. 1). In general, the organization of collected health data into relevant fact sheets and community health assessment may be regarded as an efficient way to share this data and inform the public and stakeholders about the community’s health problems and concerns.

It goes without saying that the person’s mental health is highly essential for his or her interpersonal relations, family, and individual well-being. It plays an important role in the ability of any citizen to contribute to society. According to the Community Health Assessment, in Hennepin County, 8% of adults aged 25 and older have frequent mental distress (FMD) on a constant basis (“Frequent mental distress,” n.d.). At the same time, FMD rates vary from 5% to 14% across the regions of Hennepin County, and the highest rates belong to Minneapolis Central and Minneapolis North (“Frequent mental distress,” n.d.).

Moreover, education, socioeconomic status, health, and the social perception of sexual orientation have a considerable impact on residents’ mental health. In other words, US-born Black people of low education and low income “reported a disproportionately high rate of FMD compared to other residents in Hennepin County” (“Frequent mental distress,” n.d., p. 2). Adults with diabetes or disabilities and obese people suffer from FMD more frequently than other community members. Current smokers and individuals with a lack of physical activity have significantly higher rates of mental distress than other citizens as well. In addition, the FMD rates of residents identified as LGBT are reportedly twice as high as FMD rates of non-LGBT residents (“Frequent mental distress,” n.d.).

Concerning the mental health of adolescents, collected data demonstrate disturbing results. In 2016, approximately 24% of 11th graders in Hennepin County, especially in suburban areas, reported having particular signs of depression (“Adolescent mental health and treatment,” n.d.). In turn, more than 17% of 9th graders reportedly had long-term emotional, behavioral, or mental health problems (“Adolescent mental health and treatment,” n.d.). In general, race, gender, and poverty are directly connected with the occurrence or absence of anxiety, depression, and other disorders. Low-income students, girls, Hispanic, and Black adolescents of any grade report having chronic mental health issues more frequently in comparison with non-low-income students, boys, and students of other nationalities (“Adolescent mental health and treatment,” n.d.).

Depression, along with other mental disorders, feeling alone, drug or alcohol use, and family history of mental illness are regarded as common risk factors that may lead adolescents to suicide. It is identified as “the third leading cause of death among adolescents in Hennepin County and across Minnesota” (“Adolescent suicidality,” n.d., p. 1). In 2016, at least one in ten 9th graders in Hennepin County, especially in suburban areas, seriously considered suicide during the past year (“Adolescent suicidality,” n.d.). Approximately 3% of students of 8th, 9th, and 11th grades reportedly attempted suicide within the past 12 months (“Adolescent suicidality,” n.d.). Similar to the previously described situation related to mental disorders and depression, socioeconomic status, race, and gender influence adolescent suicidality – low-income, Hispanic, and American Indian students consider and attempt suicide more frequently that other graders (“Adolescent suicidality,” n.d.). In addition, girls of any grade are “almost twice as likely as boys to consider suicide” (“Adolescent suicidality,” n.d., p. 1). However, according to collected data, in Hennepin County, males die by suicide at disproportionally high rates.

Nurse Leader Interview Summary

Role of the Nurse Leader

The role of public health nurse and care coordinator in HCMHC implies constant assistance, coordination, and intercommunication in order to provide a high quality of health care in medical settings. A public health coordinator works with patients and their family members to ensure that they receive all necessary information concerning health conditions and potential treatment. In addition, a health coordinator episodically follows up with pharmacies, case managers, patients who miss appointments, group home staff, and personnel who miss patient-related medical forms or other paperwork. The duties of public health nurse additionally include the arrangement of outside laboratory work, the obtainment of results, and assistance with setting up appointments for outside referrals, the identification of case management teams, date tracking, and coordination with the County Attorney’s office. Moreover, the participation in care conferences that involve multiple health care providers and agencies both in Hennepin County and other states is obligatory as well.

In general, the role of public health nurse and care coordinator in HCMHC aligns with the defined role of a competent health care professional and leader. A master’s-prepared nurse should know how to apply decision-making and leadership skills “in the provision of culturally responsive, high-quality nursing care, healthcare team coordination, and the oversight and accountability for care delivery and outcomes” (American Association of Colleges of Nursing, 2011, p. 12). In addition, a qualified health care professional assumes his or her leadership role for the efficient implementation of quality improvement initiatives and uses effective communication skills, improvement science, and quality processes to ensure patient safety for individuals and the community in general. Moreover, the role of a nurse leader may be characterized by multitasking, the availability of time management skills, and stress resistance.

Organization’s Characteristics

As a matter of fact, the main strength of HCMHC is its highly efficient performance and the provision of high-quality health care delivery. The center efficiently serves its target population and uses the whole potential of its staff that annually participate in quality improvement programs. In addition, HCMHC successfully implements evidence-based practice that traditionally includes problem formulation, the search and appraisal of relevant data and literature, the implementation of evidence, and the evaluation of its results in order to modify the intervention for better health outcomes. At the same time, the inferiority of the organization’s technological infrastructure may be defined as the major weakness of HCMHC. At the same time, this organizational drawback is highly essential in the present day. Due to the pandemic, communication with patients is substantially limited, however, the majority of clients have no access to video and phone services of the center due to technological constraints.

Recommendation for Organization Change

It goes without saying that HCMHC currently requires certain organizational changes to improve its performance. Moreover, these changes are highly essential for patients and fully correspond to their actual needs as the majority of basic services currently become unavailable. First of all, the COVID-19 Access Solutions QI workgroup should identify barriers to engagement in the center’s care during the pandemic. Clients for whom current practices are inaccessible should be identified as well, and if they cannot use video or phone services, they should have an opportunity to come to the center and use an iPad placed there as an exception. Moreover, electronic health records should be available for patients as well for control over their health conditions. In general, implemented changes are expected to improve the people’s access to the center’s services by at least 10% in the next months as measured by appointment completion data. The HCAHPS survey is applicable to measure patients’ updated perspectives of patients’ care as well.

Conclusion

The Hennepin County Mental Health Center (HCMHC) is a medical organization that serves children, adolescents, and adults with severe emotional disturbance, depression, serious mental diseases, and substance use disorders. It provides high-quality and low-cost mental health services for the residents of Hennepin County, Minnesota, and individuals who may encounter particular barriers to care. With the help of a highly experienced team under the supervision of competent leaders, HCMHC provides a comprehensive and client-oriented treatment that aims to promote patients’ self-efficacy, general wellness and recovery, and life enhancement. It goes without saying that the person’s mental health is highly essential for his or her interpersonal relations, family, and individual well-being. However, such factors as racial discrimination, poverty, health, education, gender, and the social perception of sexual orientation have a considerable impact on the mental health of adults, children, and adolescents. In general, HCMHC may be characterized by efficient performance and the provision of high-quality health care to the county’s residents. At the same time, the center currently requires certain organizational changes to improve its performance and provide access to its services for all patients.

References

Adolescent mental health and treatment. (n.d.). Hennepin County Public Health Assessment Team. Web.

Adolescent suicidality. (n.d.). Hennepin County Public Health Assessment Team. Web.

American Association of Colleges of Nursing. (2011). The essentials of master’s education in nursing [PDF document]. Web.

Clinics and services. (n.d.). Hennepin County Minnesota. Web.

CountyOffice.org. (n.d.). Health Departments in Hennepin County, Minnesota.Web.

Frequent mental distress. (n.d.). Hennepin County Public Health Assessment Team. Web.

Public health data. (n.d.). Hennepin County Minnesota. Web.

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