Proposal Development Paper

Proposal Development Paper






The patients and the community are able to get health care services due to the work done by the management of health care and this even involves the satisfaction of the medical experts and practitioner. There are some diseases which are life threatening and so needs to give special care. So management of such diseases is regarded as a health care issue and it must be addressed by all stakeholders. Taking this regard, one such health care issue is diabetes and for this, many changes have to be done in the management of this disease so that the patients, families and the delivery of entire health system are benefitted. The management of diabetes Type II needs some change and I propose a major change in it in this paper. When diabetic patients are handled, there occur some inefficiency which is faced by the patients and health facilities. All these inefficiencies are addressed in this change project.


All the relevant statistics are taken into account while proposing a change and also it is associated with the improvement in the self-management aspect of the disease. The number of patients suffering from diabetes in increasing day by day and this matter has to be taken seriously. Thus, the management of diabetes needs to be changed mainly the point of view related to the self-management. There is need to increase the control of the people and for this, the community should be allowed to play an important role. It is obvious that with the involvement of the community, there will be improvement in the performance of these patients and also overall costs will be lessened (Haas, Maryniuk, Beck, Cox, Duker, Edwards &  McLaughlin, 2013).


This project is selected by me mainly due to the fact that while managing the chronic condition, physicians either give very little assistance or no assistance at all to the patients and so they do not know he way of managing their disease. Such patients require that physician devote much time in managing them but it is difficult for the patients to have all the time. Health is not able to be successful in the country as well as in all over the world due to presence of a major problem and that is diabetes. It is estimated that in the developed world as compared to today, there will be increase of one percent in the number of people suffering from diabetes by the year 2030. So there will be about 200 million people who will have this disease. Also health organizations and government agencies have done studies which stated that there is continuous growth in the problem and there will be millions of people who will be suffering from this disease and so in order to manage this disease in millions of people, there is need to have a new approach. This epidemic is growing and this can be effectively dealt by providing required knowledge to the patients so that they can handle the condition in a better way. Also there should be change in the model for the health care providers and experts. In all the efforts which are done in order to manage the condition, the main priority must be given to the patients. It is shown in the data that most of the patients have to suffer a challenge if they are suffering from type 2 diabetes. It is shown by the National Institute of Health Studies that diabetes is a common disease in the adults who are more than twenty years of age and 13% of such adults have type 2 diabetes. Also it is indicated that among these patients, 40% don’t know about the diagnosis of the disease. Also those people who are above 65 years of age are more prone to diabetes and 30% of these adults are pre-diabetic and diabetes is common in about third of the adult population (Holt, Nicolucci, Kovacs Burns, Escalante, Forbes, Hermanns & Munro, 2013).


It is for sure that this challenge can be addressed in a better way if proper information is provided to the individuals especially those who are suffering from this disease and those who are vulnerable. Also practical application of other approaches proves beneficial for them. I believe that it would be of great help if the information and knowledge of the effect of diabetes is provided to the health care providers as well as to the public. The information can be circulated in a better way by empowering the communities. It is essential for the individuals to bring changes in the attitude and behavior and they need to be aware of the advantages of health education. There is requirement of education and empowerment in health related issues and for personal control. All these lead to increase in the self-belief, self-esteem and self-efficiency of the patients. It is essential that all the stakeholders are involved in some way in this practice and this change model is proposed by me.


For the process of change in the management of diabetes, the patient is the most important and forms the focus. So it is important that all the stakeholders are involved in the process. There is need to bring change in the self-management. For this, the patients must improve their dietary intake and should do exercises regularly. The populations which have high obesity levels must incorporate activity so that their body weight gets reduced. Taking into account the community perspective, the individual must be focused on in the change project. Thus, in this project the stakeholders who are involved are mainly patients, families, caregivers, community, health care providers and medical practitioners. I propose that in the project, there is active interaction between the patients and the relevant stakeholders. And if there is dissatisfaction among the patients, they are able to show that. It is observed that increase in weight of a person leads to obesity and also lifestyle conditions like diabetes develops. So in the management plan, weight management issues must be considered and given importance. The weight management about diabetes is associated with some existing models and these have not been identified to be at important levels and solutions are not there with which the treatment can be managed by the patients themselves at a personal level.


It is taken into consideration that the condition of the patients might not be very good to learn about the diagnosis. So it is the responsibility of the nurse or community health provider to plan a communication plan after consulting with the family so that patient is able to deal with the diagnosis easily (Holt, Nicolucci, Kovacs Burns, Escalante, Forbes, Hermanns & Munro, 2013). The patients may have a experience about the treatment and this has to be known and understood by the nurse which is possible only if she develops a rapport with the patient. Also it is essential that this important information is communicated by the nurse in an honest way(Haas, Maryniuk, Beck, Cox, Duker, Edwards &  McLaughlin, 2013).  By developing rapport, it is also possible for the community nurse to answer to the questions that are asked by the patients in a better way. There will be implementation of the change plan on the basis of the rapport which is established between the community nurse and the patients. The experience gained by the patients needs to be shared with others and this has to be encouraged by the nurse. This experience needs to be shared through the support groups which are focused by the change project in providing information regarding the importance of proper diet, exercise and weight management. These all are regarded as the self-management measures which are useful in fighting against diabetes. The entire project can be implemented on the basis of the communication plans where all the issues of the community, government agencies and health care providers are communicated and the nurses need to respond to them. The community nurses are regarded as very important in the community health care delivery and so the implementation of the project is associated with making them the central point of attraction.


All the team members have to perform certain roles and these roles forms the basis of the implementation of this project. The key focus of the project is obviously the patients but the effect of the project design on the families, community and the all health care sector needs to be proved by the team members. The implementation plan is associated with the partnerships, collaboration and teamwork and these are included in the roles that are assigned for all the members. An important role is played by the nurses where they are responsible for establishing the effective communication so that the patients are benefitted. There is need to transfer the knowledge and the required equipment and information in the facilities and this is done by collaboration between the community leaders and the health care providers. This they do by taking help of the alternative means and thus, the plan is benefitted. There must be consultative meetings organized by the leaders along with the community members where matters related to funding and other administrative problems can be solved. Thus, in all facets of project, an important place is occupied by the role which is played by the community. The correct information is provided by the health care providers who are also responsible for providing facilities and coordinating with health agencies of the state and federal like CDC (Center for Disease Prevention) and NIH. The entire project is implemented successfully by the input of the health care providers. An important part of the plan are the patients and so their roles are central which include effective circulation of information for which they need to develop an enabling environment around them. Also it is required by them to develop support groups in their communities. Apart from this, the members should be able to communicate easily with the community nurse for which they need to enhance the communication channel (Haas, Maryniuk, Beck, Cox, Duker, Edwards &  McLaughlin, 2013).


There can be obstacles in the implementation of the plan which need to be identified and the team is required to develop sound strategies by which these problems can be solved. By developing these strategies, it becomes sure that the change in self-management of diabetes is implemented successfully. The teamwork among the members is supported by the first strategy and then there is collaboration with all the stakeholders and government at all levels. Then after is the second strategy in which the area where change is required at particular interval is identified. Also the need that arises in the shorter periods is also identified. After this, the evaluation plan is formed in the third strategy in which evaluation of all the activities is done. This is followed by the formation of report about the performance of the stakeholders. But even if these strategies are followed, it can be possible that the coordination and collaboration may not be adequate. This can lead to development of obstacles in the implementation of strategies. Also it may be possible that the patients may not be comfortable in sharing their experience in the groups and so this can also arise as an obstacle. Also if there are failure of stakeholders in identifying and addressing legal provisions in existing laws at all levels, then there can be obstacles related to legal challenges as well. This can lead to development of ethical issues related to the privacy of the patients and thus, it becomes very essential for the team to take necessary steps so that these matters can be solved (Holt, Nicolucci, Kovacs Burns, Escalante, Forbes, Hermanns & Munro, 2013).







It can be concluded that if this proposal is implemented that health issues will be solved by the communities and solutions will be found so that patients are able to live good lives even if they are suffering from diabetes.







Haas, L., Maryniuk, M., Beck, J., Cox, C. E., Duker, P., Edwards, L.& McLaughlin, S. (2013).


National standards for diabetes self-management education and support. Diabetes care, 36(Supplement 1), S100-S108. Am DiabetesAssoc


Holt, R. I. G., Nicolucci, A., Kovacs Burns, K., Escalante, M., Forbes, A., Hermanns, N. &


Munro, N. (2013). Diabetes Attitudes, Wishes and Needs second study (DAWN2™): Cross‐national comparisons on barriers and resources for optimal care—healthcare professional perspective. Diabetic Medicine, 30(7), 789-798.Online: Wiley Online Library



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