Care Coordination Plan for Heart Disease

Write and explain this plan of care to the patient, Andrew Smith regarding his diagnosis of heart disease, and the care plan. ” Build on the preliminary plan of heart disease, to complete a comprehensive care coordination plan. (Paper is attached please review) ” Design patient-centred health interventions and timelines for care. o Address three patient health issues. o Design intervention for each health issue. o Identify three community resources for each health intervention, so the patient may make an informed decision about what resources to use. Your final plan should be 5-7 pages in length. Support your care coordination plan with peer-reviewed articles, course study resources, and Healthy People 2020 resources. Cite at least three credible sources no older than five years. 1. Make ethical decisions in designing patient-centred health interventions. Defend decisions based on the code of ethics for nursing. 2. Identify relevant health policy implications for the coordination and continuum of care. 3. Use the literature on evaluation as a guide to compare learning session content with best practices. 4. Describe what the literature says about effective care coordination and patient satisfaction versus experience, including how to align teaching sessions to the Healthy people 2020 document. 5. Collaborate with patients and family to achieve desired outcomes. ” Design patient-centred health interventions and timelines for care. o Address three patient health issues. o Design intervention for each health issue. o Identify three community resources for each health intervention, so the patient may make an informed decision about what resources to use. ” Consider ethical decisions in designing patient-centred health interventions. o Consider the practical effects of specific decisions. o Include the ethical questions that generate uncertainty about the decisions you have made. ” Identify relevant health policy implications for the coordination and continuum of care. o Cite specific health policy provisions. ” What does the literature say about the evaluation of care coordination? o How might revisions to the plan improve future outcomes? ” What does the literature say about: Effective care coordination and patient satisfaction versus experience? o How to align teaching sessions to the Healthy People 2020 document? Andrew Smith, a 52-year-old African-American male with the early progressions of heart disease. His cholesterol is 232, he has a BMI of 40, and his blood pressure readings have shown mild hypertension. Mr Smith is a cigarette smoker of 32 years and admits to being rather sedentary. He states he loves greasy and fatty food and drinks beers almost every night. He is adamant that he wants to regain control of his health but is very apprehensive about treatment as well as quitting smoking. He’s afraid he’ll gain more weight and admits to having a very stressful job, in which smoking is his release.

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