Polypharmacy Effects on the Geriatric Population

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Introduction

The effects of polypharmacy in the geriatric population have in the recent past increased resulting in more hospital admissions of aged persons and wastage of a lot of resources. This necessitated the Presbyterian Seniorhealth clinic to lead a registered nurse driven SafeMed program, which attempted to reduce the adverse effects of polypharmacy on the aged patients. A group of five members developed a Quality Improvement Evaluation Plan for assessing the effectiveness of the SafeMed program. This paper is anticipated to evaluate the diligence and usefulness of this program evaluation and not the program itself and attempts to research whether procedures were adopted and matters tackled that involved a strong and logical program evaluation (Goedert, 2008).

Logic model

The planners have formulated a very informative and clear logical model on how to go about the program. By aligning work in this manner, planners have a more comfortable way to classify the work and evaluate it. The most significant insights in this model are efforts to measure the outcomes of the program. The logic model is very clear and detailed and presents a clear picture of how the SafeMed program will be implemented. The planners have placed emphasis on the outcomes, particularly the long-term results of the program from their logic model. However, the outcomes in this program can be accomplished through practices autonomous of the program and thus the appraisal of those results would imply program achievement when external factors and outputs influence the results.

Description of the program development

The program description clearly clarifies the SafeMed program’s aim, phase of development, actions, and the capability to improve health. This description also presents a public understanding of SafeMed and what the evaluation is capable or incapable of delivering. The description helps to lay the ground for outlining the program evaluation questions, understanding the focus of its design, and linking program development and appraisal. However, the description is not clear about the resources obtainable to execute the program and fails to present the environmental framework within which SafeMed is to be carried out.

Program history

The history section summarizes the contents of the program by outlining the main issues in the evaluation plan. The program history gives a detailed overview about the evaluation plan. It explains who the planners are and gives an insight about what SafeMed program entails, its benefits, and stakeholders involved. This description assists stakeholders and anyone studying the program to understand the program contents, intentions, and projected outcomes. The planners have also outlined the stakeholders of the program and their roles in developing the program.

Problem program addresses

The program evaluation plan has clearly outlined the problem addressed by the program: the effects of polypharmacy on older people. This section has also provided statistical facts showing the effects of polypharmacy to people age 65 years and above. The problem addressed by SafeMed seems critical to warrant the establishment of a remedial program and thus enhances the significance of the program. The stated problem of SafeMed assists to drive the prospects and to fix the borders for what the evaluation plan is able or unable to deliver. If SafeMed program is successful in resolving this problem, the polypharmacy effects among the older people would decrease thereby cutting the rising costs of hospital admissions and wastage of resources on older persons (Gardella, Cardwell, & Nnadi, 2012).

Target population

The program evaluation plan also provides useful ways of identifying the program’s target population and the stakeholders involved in the program. SafeMed program targets patients aged 65 years and above and who are currently undergoing a series of at least four medications and receiving medical attention at the Presbyterian Senior Health clinic. The choice of older people from the age of 65 years is logical since people who attain this age become more vulnerable to various old-age illnesses and hence subject to polypharmacy. Additionally, the choice of Presbyterian Senior clinic was well advised since the healthcare records a high readmission percentage associated with adverse drugs’ effects on the older people (Hilmer & Gnjidic, 2008). However, the plan does not provide the number of patients that the healthcare attended to, and those that the planners assessed.

Program goals

The program’s goal is well stated in the evaluation plan; bringing down polypharmacy in the older people. The program’s goal is effective in determining the recognition of stakeholders, choice of assessment questions and understanding the right timing of assessment activities. The program’s goal has also assisted in ascertaining the connection between reasons and projected application of the assessment data.

Program Objectives

The objectives of every evaluation plan serve as the benchmark for its success or failure. The planners of the SafeMed program have observed the SMART objective criteria through adhering to the six quality objectives of the Institute of Medicine (IOM). These aims encompass safety, timeliness, patient’s care, effectiveness, competence, and equitable care (Gardella, Cardwell, & Nnadi, 2012). The plan gives specific statements of what SafeMed will achieve in a specific duration. The objectives are also measurable as they answer the questions of what to execute, which activity, when, and how program activities will be carried out. The plan is realistic as it provides concrete things of what the program can accomplish and within the specified six months period. The accuracy objective of the evaluation plan is evidenced by the action of planners to conduct a contentment survey on the program to assess the participants’ views about the program.

Program resources

The planners have revealed the team of experts responsible for executing the program. The planners have stated that the program will be steered by a multidisciplinary team that will encompass one registered nurse, primary care provider, and a pharmacist. The executive leader and quality management controller will oversee the effective delivery of the program. Although the planners have clearly delineated the program resources available to steer the program, they have not provided a clear picture on whether these resources are sufficient and capable of coordinating all the program’s activities and whether the resources will adequately cater for the 50 patients selected (Hilmer & Gnjidic, 2008).

Activities being considered

The activities of the program are organized in a very clear and logical manner. The duties of re-examining, selecting participants, and setting consultation timelines are given to the registered nurse. The pharmacist is accorded the responsibility of conducting monthly telephone consultation to patients and collecting patients’ perceptions about the program. The arrangement of program’s activities reveals the harmony and teamwork of the program facilitators. The program gives the registered nurse the absolute privilege of randomly selecting 50 patients to partake in the program without involving other stakeholders. However, reliance on her decision alone may be misleading, and the plan should have incorporated the pharmacist and an executive leader at the selection stage.

Long term program effects

The program’s long term result is to enhance standards of living through medication observance as confirmed by decreased adverse drugs’ effects, reduced low- density lipoprotein, and blood pressure levels. These long term goals will be a constant guide and a reference to planners in evaluating whether the desired results were achieved. These outcomes will help planners to evaluate the program constantly and remain focused until they achieve this goal (Little & Morley, 2013).

Engaging Stakeholders

The stakeholders for the SafeMed program comprise the pharmacists, patients, family members, health insurance firms, the QIC, and administrative management. The plan has clearly outlined the roles of the various stakeholders involved in the program implementation. For instance, the registered nurses will serve as main resources by monitoring patients’ adherence and providing education to participants (Pervin, 2008). Administrative leaders should ensure that wastage of resources is curbed, and that healthcare services are delivered effectively. However, the plan does not indicate how the various stakeholders will collaborate and how they will execute their mandates without conflicts and collisions with each other. The evaluation plan does not have any mechanisms to assess the stakeholders’ effective understanding and execution of their mandates.

References

Gardella, J. E., Cardwell, T. B., & Nnadi, M. (2012). Improving medication safety with accurate preadmission medication lists and postdischarge education. Joint Commission Journal on Quality and Patient Safety, 38(10), 452-458.

Goedert, J. (2008). Time to roll for SafeMed. Health data management, 16(5), 47.

Hilmer, S. N., & Gnjidic, D. (2008). The effects of polypharmacy in older adults. Clinical Pharmacology & Therapeutics, 85(1), 86-88.

Little, M. O., & Morley, A. (2013). Reducing polypharmacy: Evidence from a simple quality improvement initiative. Journal of the American Medical Directors Association, 14(3), 152-156.

Pervin, L. (2008). Polypharmacy and aging: Is there cause for concern. Accounting Research Network, 25(1), 6-7.

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