Question

Create a short managerial case, the Board believes offering specialized care for patient's with cardiac diseases will meet an unmet need in the community but want to be sure they are making the right decision. You are directed to identify the current and future need for cardiac services based on the community population characteristics and current use of cardiac services at your hospital.)

List all types of evidence that need to be collected, explain why;

-Name the epidemiological data, studies, and metrics to support the decision-making process, explain why.

-Explain the decision-making process

Answer 1

1. The following methods can serve to improve measurement for global cardiovascular diseases by providing information for feedback and decision making from multiples sources (such as surveillance, intervention research and program evaluation, clinical practice data, and policy analysis) and at multiple levels like national, sub national,communities ,household and individuals.

Measurement for Policy makers: For policy makers at all levels, measurement provides information that can motivate changes in priorities and policies, influence public opinion, help select and set priorities for the allocation of resources and manage intervention approaches. The discipline of policy analysis strives to provide objective data and analyses to support rational policy decisions (i.e., “evidence-based policy”).

Population measurement: Population and sub population metrics on Cardiovascular disease and related risk factors can document outcomes that are typically to understand and communicate for decision making for stake holders and also for other policy makers.Population data can also have opportunities to more effectively target, or adapt CVD interventions if the data are collected in a way that allows quantification of variations in CVD risk factors and outcomes, or access to care between genders or among regions, ethnic groups, socioeconomic strata, or rural populations.

Systematic surveillance : The presence of active systematic surveillance mechanisms that can analyze and report data is important for identifying both program and policy impacts on CVD in developing countries for multiyear studies.

a) Vital Registration Systems: It is one of method of collecting vital population data is through the use of vital registration systems (also called civil registration systems or sometimes death registries). It can provide the critical information necessary to monitor a country’s disease burden and associated needs through the collection of cause of death statistics, including measures of CVD-related causes of mortality. The functionality and capacity of vital registration systems in developing countries varies substantially due in part to the finances and technical capacity required to propose them. Theses system in low and middle income countries ,there reins a lack of leader ship in effort to capitalize because both the implementation costs and benefits are spread across a broad range of sectors at the national government level.

b)Health Information Systems :It can another opportunity for systematic data collection. It offers policies and program that can attempt to alter risk behavior among a broad cohort of individuals will often depend on these type of information system. Therefore, it is important for the global CVD community to ensure that metrics related to CVD and chronic diseases are integrated within these systems in developing countries, especially given the growing international focus on the integration and coordination of disparate.

Population Surveys: These data collection efforts have been beneficial in three ways.

a)First, they provide a cross-sectional view of the epidemic.

b)Second, they provide a measurement can tell us about the epidemic through the inclusion of more detailed indicators and analysis, which, if particularly useful, would expand and guide future measurement efforts.

c)Third, they set standards for more rigorous collection and validation processes.

                        

Assess Needs Measure context-specific disease burden using population data Assess Capacity State of current efforts, workforce, infrastructure, resources, political will Determine Priorities and Set Realistic Goals Design and Develop Interventions/Programs Design based on determinants research, demonstrated effectiveness, and likely feasibility Develop using formative research, tailoring, and adaptation for context and scale Scale depends on evidence base, resources, capacity Have the Goals Been Met? Disseminate knowledge gained Implement best practices at increasing scale Implement Interventions/Programs Monitor and evaluate inputs (e.g., costs and other resources required), processes (e.g, fidelity of implementation), and outputs (e.g, quality of delivery) Are Current Needs the Same? Evaluate Effects/Outcomes of Interventions/Programs Intermediate outcomes Health impact Are Current Priorities the Same?

2. Shared decision making is the process through which clinicians and patients they share information with each other and work toward decisions about treatment chosen from medically reasonable options that are aligned with the patients’ values, goals, and preferences.

1. For patients,decision making process become essential and crucial process as a duration of disease and treatment options that has increased.
2. Sharing decision is an iterative process that evolves a over as the patients age and quality of life change.
3. An annual cardiac failure review with patients should include discussion of currents and potential therapies for both unanticipated and anticipated events.
4. Attention to the clinical trajectory is required to calibrated expectation and guide decision making and should be included in discussion with both patients and clinicians.
5. Discussion should include risk factor and outcome beyond survival, including adverse events,functional limitations,loss of independence,quality of life and obligations for caregivers.
6. Clinicians should be responsible for initiating the development of the comprehensive plan for end of life care consistent with patient values,preferences and goals.
7. Assessing and integrating of emotional readiness of patient and their representatives is vital for effective communication.
8. Changes in organizational and structures are vital to promote high quality decision making and delivery of patient centered healthcare.