Discussion response

Discussion #1 Cardiac tamponade is a disorder that occurs by traumatic, or by non-traumatic stressors. Cardiac tamponade occurs when fluid or blood fill the pericardial sac impairing cardiac filling. Cardiac tamponade may occur progressively over time allowing for structural adaptations to occur to the pericardial sac which may not create an acute life-threatening situation but will nevertheless require medical intervention. Alternatively, this disorder can have a rapid onset and immediately preventative action is required to prevent loss of life. In a military, combat, setting cardiac tamponade typically occurs from blunt-force trauma to the upper torso. In some cases, penetrating fragment wounds, where fragments enter and traveled through the body to the upper torso can cause hemorrhagic cardiac tamponade. Opposed to traumatic cardiac tamponade, as mentioned previously, one additional stressor which may trigger cardiac tamponade is through drug induced reactions (Eckman & Share, 2013). Clozapine, classified as an atypical antipsychotic drug, is recommended to help reduce the suicidal ideation, and aggressive behaviors in schizophrenic patients (Lee et al., 2018). Clozapine has been shown to cause cardiac tamponade, myocarditis, and other cardiovascular diseases (Othman et al., 2014). Behavioral health providers (BHPs) interact with patients and clients who are diagnosed with disorders across the entirely of the Diagnostic and Statistical Manual- 5th Edition (DSM-5). In interacting with such a variety of individuals who are treatment with various psychotropic medication comes possibilities where these patients or clients may have adverse effects. BHPs are valuable team members as they can identify key adverse side effects of psychiatric medications and possible life-threatening reactions. BHPs provide patients education on the possible side effects of medications and offer support such as 911, and other avenues to call for help in the event adverse symptoms arise. Additionally, behavioral health providers can offer patients and families information on where to engage in support groups that offer counseling and peer guidance, empowering the both the patient and their families and friends. References: Eckman, M., & Share, D. (Eds.). (2013). Pathophysiology made incredibly easy (5th ed.). Lippincott, Williams, & Wilkins. Lee, H., Scolieri, B. B., & Mullick, P. K. (2018). Learned lessons from patients who take clozapine: A case study. Perspectives in Psychiatric Care, 54(4), 457–461. https://doi– org.libproxy.lamar.edu/10.1111/ppc.12245 Othman, Z., Ahmad, F., Abdul Halim, A. S., & Ismail, N. N. (2014). Clozapine-induced myocarditis and pericarditis. International Medical Journal, 21(6), 539–540.

Discussion # 2 Dr. Lynn saw a vision of a population health management program, but she did not think about outside contributing factors that could negatively affect her program. To re-launch this program, Dr. Lynn would have to go back to the drawing board. The Model for Improvement would be helpful for Dr. Lynn to re-launch her program. This model focuses on four steps to achieve a goal. The steps are act, plan, study, do (Ogrinc et al., 2018). Dr. Lynn had a broad horizon of patients she was willing to incorporate into the population health management program. Since she is the only DBH, she should narrow down her screening assessments to focus on one population of patients. To choose which population would be more beneficial, she would have to research what is more in demand as well as what was already available to the community. Solely implementing the AUDIT to assess patients with substance abuse disorder, as well as SBRIT would be a good start in becoming more focused in one area. If there is one focus as well as one main population, it will be easier for Dr. Lynn to assess as well as treat her patients. To successful implement a population health management program, there are a few factors to consider such as: Considering all factors that affect a person’s health; Defining and introducing strategies that provide coordinated care across the continuum; Engaging consumers in support of their own health; Employing caregivers and technologies best suited to a person’s needs; Leveraging established community and social services; (Proctor et al., 2016) The clinical team behind Dr. Lynn is very supportive and believes in her. Dr. Lynn is very respected at the clinic, but her team members believe that she can succeed. Having this type of support makes it easier for Dr. Lynn because they all share a common goal. Dr. Lynn will have to represent the program to the clinical team with the new improvements to show them that she has made the changes necessary for the program to succeed. The team has been supportive throughout this change and will give her a second chance with ease once they see the changes. To reduce waste, Dr. Lynn must encourage the lean mindset throughout her program. To implement lean, they must do more with less. Using a value steam map can determine any step of the operation that does not add value (Scoville, 2014). References: Ogrinc, G. S., Headrick, L. A., Moore, S. M., Barton, A. J., Dolansky, M. A., & Madigosky, W. S. (2018). Fundamentals of health care improvement: A guide to improving your patient’s care (3rd ed.). Oak Brook Terrace, IL: Joint Commission Resources. Proctor, J., Rosenfield, B. A., & Sweeney, L. (2016, January). Implementing a successful population health management program. https://www.usa.philips.com/c-dam/b2bhc/us/Specialties/community-hospitals/Population-Health-White-Paper-Philips-Format.pdf (Links to an external site.). Scoville R, Little K. Comparing Lean and Quality Improvement. IHI White Paper. Cambridge, Massachusetts: Institute for Healthcare Improvement; 2014. (Available at ihi.org)