Program Design, Implementation and Evaluation

Introduction to Program Design, Implementation and Evaluation

A needs assessment is a comprehensive approach to determining a population's unmet health and welfare needs and finding out solutions to those needs (Wright, Williams & Wilkinson, 1998). This involves an epidemiological and qualitative approach to prioritize the medical needs and cost-effectiveness of health care and the perspectives of patients. This strategy requires to combine health, economic, and legal aspects of needs. Health care is in the middle of a transition driven by powerful forces of cost control and innovation, including cancer care. In Australia, cancer has been a very common health illness in the population (AIHW, 2018). Although financial forces may be new for public healthcare, and cancer treatment in particular, where price cuts occur frequently alongside performance improvements. Consulting populations is a vital way to consider factors that influence their health and quality of life to identify the needs of vulnerable groups that may not be included in regular statistical surveys. In this essay, the needs assessment for cancer disease and the challenges along with the improvement programs have been discussed.

Needs Analysis Approach for Cancer Control Service

Cancer care providers are expected to improve efficiency as well as cut cost of the cancer health care services. Such changes, however, are unlikely to happen without a much clearer understanding of the needs of patients and families and the challenges that affect them (Smith et al., 2013). When those requirements are better known, it is possible to develop strategies that will improve adherence to the needs. These strategies will be effective if they are done on state levels as it easy to check the progress, challenges of the programs made after needs assessment. Current research indicates cancer survivors are grappling with a variety of acute, persistent, and late cancer treatment and relapse consequences (Recklitis & Syrjala, 2017). The cancer patient faces physical, emotional, mental, financial, moral, and economic consequences. While some cancer-related issues, such as cognitive disorders and social difficulties, continue to decrease over time, other symptoms such as exhaustion, discomfort, and sleep and discomfort remain, with some cancer survivors enduring physical or psychological symptoms. Building a good model for delivering and implementing tools for assessing needs requires a collaborative effort among various stakeholders. Consider the available infrastructure and capabilities as well as the amount of needs assessment tools offered when evaluating a delivery model that would suit the state-level facility (Watkins, West Meiers & Laila Visser, 2012). The timing of the test for needs assessment is also a significant decision to be made by the state-level agencies.

Access to adequate resources is the most important factor to consider before implementing needs assessment instruments in the clinical setting at the state level. That requires appropriate personnel with ample time to perform the evaluations, as well as the additional time needed to follow up on defined needs during consultations. The type of tool chosen may be influenced by future resource constraints. Another factor in the planning stage is to ensure that, based on the needs defined in the evaluation, the sufficient resources to guide and refer survivors. The planning process at the state will include a study of community resources, services, and initiatives (CDC, 2013). The initial planning stages should involve all relevant parties to ensure that they have adequate resources to manage a potential increase in demand for their services. It also includes identifying a clinical leader to facilitate the implementation of needs assessment processes when considering the best way to implement a needs assessment model. Assign the personnel responsible for identifying needs and preparing for appropriate training of workers. Ensure the referral tools and programs are accessible until their introduction. Develop local needs assessment guidelines including how this process fits in with the follow-up care of cancer patients.

Challenges in The Needs Analysis

There are several challenges to evaluating the patient or care provider needs. It includes the lack of clarity on the best practices in initially identifying the needs; identification of possible performance measures for each need; measurement of value for the needs, use of client needs assessment data, improvement, and review efforts. First, it is necessary to link the needs assessment and highlight the dynamic relationships between needs. The review of current cancer needs assessments has to be done along with the measurement of their strengths and weaknesses. Then, recommendations for future research in this area can be done. Since cancer is a condition that has implications well beyond the patient and the family, so it is recommended that the needs evaluation concentrates on both patients and family caregivers (Wen, & Gustafson, 2004). The challenges will also involve discussing tools to assess needs that address patients and families.

Evaluations of needs are important to direct care planning, partially because many patients and caregivers do not express issues to their doctors. The critical psychosocial issues which express the needs are ignored many times. Many patients and carers conclude that cancer eventually leads to pain, sorrow, rage and misery. Many times, clinicians don't want to discuss these concerns, as demonstrated by the lack of clinician concern or inquiry required to establish substantive dialogue (Alvariza et al., 2018). Due to insufficient awareness of family and patient needs, both the costs of healthcare and needless distress are rising. In particular, significant evidence points to the detrimental impact of insufficient knowledge and support needs being met. For example, if physicians are unaware that a caregiver feels unprepared to clean a patient's wound and administer it, then there might not be adequate training; infections may, therefore, develop that will increase both discomfort and cost (Konstantinidis et al., 2019). The research that has been carried out so far often fails to explain how knowledge and support needs for patients and caregivers shift with key events such as finding that medication is no longer effective.

SWOT Analysis

Strengths

  • Branch network path with organized screening
  • Professional skills
  • Laws and regional regulations
  • Regional training
  • Regional plan for preventions

Weakness

  • Lack of social sensitivity to the preventions
  • Little awareness of women at risk of contracting cancer
  • Lack of awareness of screening
  • The absence of communication plan
  • Lack of human resources
  • Failure to update management skills

Opportunities

  • Reducing costs for inappropriate examinations and avoidable circumstances
  • Making the screening mandatory
  • Involvement of the private organisations
  • Active involvement of GPs
  • Best practices of communications
  • Incentive tools
  • Cohesion and uniformity of behaviour between the different business components.

Threats

  • Risk failing to follow the women for screening throughout the journey
  • Offer of private and competition
  • Poor collaboration between institutions and organisations
  • Misinformation or no synergistic effect of campaigns
  • Discontinuity in the programs and the path
  • Continuous rotation of decisions and change of organisational models

Program Priorities

The viewpoint of community primary care professionals on how our cancer care system operates, as they are peers who are important to the entire continuum of community cancer care. The goal of the program should be to recognize the needs of the served community, potential for improving inequalities in cancer health care and resource gaps. The program priorities should be to guide a set up for the navigation process for patients to tackle the barriers (Valaitis et al., 2017). The cancer care group needs review attempts to take stock of what is being delivered to patients with cancer, and to understand what challenges patients and their caregivers face in cancer screening, diagnosis, treatment, and survival. This is an assessment that applies to many communities and reflects the large geographic area served by the cancer program. This aims to provide a geographic summary of our service areas, their features, and programs. Focus is also put on the present and expected occurrence of cancers, the number of patients, and their demographics (age, employment, income, insurance status, and language).

An evaluation is done for the care sources and where the patient chooses to go for cancer treatment. The program goal is to determine the type of cancer treatment, patient navigation process but the evaluation itself is not designed to solve the challenges it faces. It indicates places where care should be provided. The program contains several challenges: rural environment, and cultural differences that might be faced in the future in the treatment of the patients (National Academies of Sciences, 2018). Others have far broader consequences than offering treatment for cancer: deprivation, shortage of health care professionals, vast areas of deprived community facilities. And there are far more popular, and more readily addressable, places where outcomes can be significantly enhanced by a scheme, the quality of treatment, for everybody: patients, primary care providers, oncologists, and anyone involved inpatient care. Those would be the focus immediately.

Conclusion on Program Design, Implementation and Evaluation

Cancer prevention is aimed at reducing cancer's effect on the environment and enhancing health outcomes. The regional and state cancer programs have identified major incentives to do so. Nevertheless, such guidelines, strategies, and priorities have been successfully enforced over time leading to improved health outcomes. Developments in new technology, diagnosis and treatment, and the detection of risk factors are continually changing the goalposts and cancer management plans need to be versatile and frequently revised to amend and re-prioritize targets. Specific cancer prevention plans assessment limits our ability to evaluate the overall performance of such plans. Those national and state proposals outlined ambitious strategies for reform overall. Such initiatives have the potential to dramatically reduce the incidence of cancer within the Australian community through effective frameworks, leadership, and financial assistance for planning and management.

References for Program Design, Implementation and Evaluation

AIHW. (2018). Australia's health 2018. Retrieved from https://www.aihw.gov.au/reports/australias-health/australias-health-2018/contents/table-of-contents

Alvariza, A., Holm, M., Benkel, I., Norinder, M., Ewing, G., Grande, G., Håkanson, C., Öhlen, J., & Årestedt, K. (2018). A person-centred approach in nursing: Validity and reliability of the Carer Support Needs Assessment Tool. European journal of oncology nursing : the official journal of European Oncology Nursing Society35, 1–8. https://doi.org/10.1016/j.ejon.2018.04.005

CDC. (2013). Community needs assessment. Retrieved from https://www.cdc.gov/globalhealth/healthprotection/fetp/training_modules/15/community-needs_pw_final_9252013.pdf

Konstantinidis, T. I., Spinthouri, M., Ramoutsaki, A., Marnelou, A., Kritsotakis, G., & Govina, O. (2019). Assessment of unmet supportive care needs in haematological cancer survivors. Asian Pacific journal of cancer prevention: APJCP20(5), 1487–1495. https://doi.org/10.31557/APJCP.2019.20.5.1487

National Academies of Sciences. (2018). Long-term survivorship care after cancer treatment: proceedings of a workshop. Washington (DC): National Academies Press (US); 2018

Recklitis, C. J., & Syrjala, K. L. (2017). Provision of integrated psychosocial services for cancer survivors post-treatment. The Lancet. Oncology18(1), e39–e50. https://doi.org/10.1016/S1470-2045(16)30659-3

Smith, M., Saunders, R., Stuckhardt, L., et al. (2013). Best care at lower cost: The path to continuously learning health care in America. Washington (DC): National Academies Press (US).

Valaitis, R. K., Carter, N., Lam, A., Nicholl, J., Feather, J., & Cleghorn, L. (2017). Implementation and maintenance of patient navigation programs linking primary care with community-based health and social services: a scoping literature review. BMC health services research17(1), 116. https://doi.org/10.1186/s12913-017-2046-1

Watkins, R., West Meiers, M., & Laila Visser. Y. (2012). Essential tools for collecting information, making decisions, and achieving development results. Retrieved from https://openknowledge.worldbank.org/bitstream/handle/10986/2231/663920PUB0EPI00essing09780821388686.pdf

Wen, K. Y., & Gustafson, D. H. (2004). Needs assessment for cancer patients and their families. Health and quality of life outcomes2, 11. https://doi.org/10.1186/1477-7525-2-11

Wright, J., Williams, R., & Wilkinson, J. R. (1998). Development and importance of health needs assessment. BMJ (Clinical research ed.)316(7140), 1310–1313. https://doi.org/10.1136/bmj.316.7140.1310

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