Management of diabetic mellites

The primary goal of the diabetes mellitus management is to prevent or eliminate the symptoms or to even slow their progression. The health care services are characterised by the essential attributes such as high quality care, effective and safe practices. An effective and clear leadership is required for driving and encouraging changes at various levels of health care system to achieve necessary goals and to assure patient safety. Within health care services the leadership is related to both clinical workforce and management and involves multiple challenges. Diabetes management does not require only clinical intervention for the patients but also demands for the suitable leadership strategies to foster the changes in health care settings and communities so that disease can be prevented and managed.

The leadership changes can assist health professionals to effectively manage their patients as well as vulnerable groups who needs critical attention and care. At present obesity induced diabetes among children is major concern for the health communities because improper life style is giving children a life long chronic diseases at very young age (Mutuota, Hill and Claydon, 2017). Thus best recommendations about the management of diabetes includes awareness programs along with the self care and life style changes. For the management of diabetes there is need of close monitoring of routine activities, eating habits and disease symptoms. Thus the key purpose of this project is management and early recognition of the disease so that cost and severity of the diabetes mellitus can be controlled (Simmons, Wenzel and Zgibor, 2016).

The major goal of the diabetes treatment and management process is to control the blood sugar level so that progression or symptoms worsening can be prevented. Type 1 diabetes can be managed through exercise, dietary changes as well as insulin while type 2 diabetes is manageable by weight reduction, dietary changes, insulin and non-insulin medications. The management strategies of diabetes depends upon variety of factors such as health status and medical history of the patient, impact of medication on patient, accessibility and effectiveness of health care system and management cost for each patient (Preshaw and Bissett, 2019). The goal of diabetes management is to maintain the normal value of blood glucose level, triglyceride and cholesterol. The management practices in correct direction can also assist in restricting the possible emergence of diabetes related health problems.

Aim

To manage the symptoms and complications related to diabetes mellitus for reducing the economic cost, mortality and morbidity. The project also aims at improving the quality of life by providing relieve to symptoms and promoting regular monitoring of diabetes progression so that health complications can be prevented by delivering timely intervention.

Objective

• To enhance the health outcomes and productivity of life of patients of diabetes.
• To manage the symptoms and development of diabetes mellitus in patients and vulnerable groups.
• To lower the economic burden, mortality and morbidity of diabetes.

Justification

The number of type 2 diabetes mellitus patients has been rising significantly. At present nearly 4 million people in UK are living with diabetes (Diabetes Prevalence, 2019). It includes both diagnosed and undiagnosed individuals. The factors such as symptoms management, life style, eating habits and access to health care services plays crucial role in managing both chronic and acute complications related to diabetes. Thus it is essential to manage diabetes mellitus so that number of deaths and vulnerable people can be controlled. The obesity is one of the key reason for increasing prevalence of diabetes mellitus.

The lack of effective diabetes management practices and programs is also one of the key force which is increasing the prevalence of the disease (Hopkins, Taylor and Lean, 2019). Thus it is required to develop a project which aims at management practices. The project is vital for improving the education and awareness among both communities and health professionals. It will guide service providers so that they can adopt suitable nursing and health care interventions to assess the care needs of individuals and how they can reduce the severity and complexity of the disease.

In addition to the prevention of disease there is also need of improving the symptom management of the patients so that long term risk factors and complications of the disease can be avoided or delayed. The improved management practices adopted by health care professionals is also helpful in managing the economic stress associated with the disease (Wisting and Snoek, 2019). The treatment such as insulin therapies, treatment cost for other risks factors or diseases originated from the diabetes mellitus also needs financial assistance or home care support services.

Diabetes management requires close monitoring and person centred care approach for the patient. Thus multidisciplinary teams must work in collaboration with each other so that they can identify and fulfil the care requirements of the patient (Morris and Bain, 2019). The leadership plays a crucial role in the quality of services and thus it is vital to understand the different approaches of leadership and change management for making the project successful and improving the diabetes management practices.

Statement of Intention

The purpose of this project is to increase the awareness among communities about the management of diabetes mellitus. The health professionals must adopt suitable strategies to support communities so that diabetes risks can be prevented and symptoms of the patients can be managed. The project also intend to enhance the quality of life of diabetes patients by improving the management and leadership attributes of health care professionals.

Background

Diabetes mellitus is metabolic disorder in which blood sugar level is elevates over time. The project targets the UK population in which diabetes prevalence is increasing rapidly. It is estimated that by 2025 there will be around 4 million people suffering from type 2 diabetes. In UK disease is growing rapidly at high rate and is now one of the most common life threatening disease. It is also predicted that at present UK have around 549, 000 people who have diabetes which is yet to be diagnosed. Thus there is strong need to manage the disease so UK population can be provided a quality life. The disease is also considered as life threatening due to its related health complications which includes nerve damage, cardiovascular diseases such as stroke or heart attack, retinopathy, skin diseases, Alzheimer and hearing impairment (Tay, de Bock and Mayer-Davis, 2019).

For the study different population groups such as children suffering from obesity, children with family history of diabetes and people diagnosed with diabetes will be taken into account.. Thus diabetes management project aims at prevention and control of the diabetes among vulnerable and affected groups by improving health care interventions and management practices.

LITERATURE REVIEW

Diabetes Mellitus

According to Bird and Turner, (2016) accurate and timely diagnosis of the diabetes is one of the essential aspect for the management of diabetes. The healthcare leaders put a major emphasis on diagnostic criteria. In addition to this productive management not only prioritise the controlling of blood glucose level only but also give priority to diabetes associated risk factors like obesity, smoking and hyperlipidaemia and blood pressure monitoring. Self care is one of the most effective treatment strategy in diabetes management. Thus the first step of management involves the diabetes education to communities and individuals. Vulnerable groups and patients must be encouraged and supported to actively monitor and manage their health outcomes. Self monitoring strategies enhances the safety, quality and effectiveness of treatment therapy.

In the same context Purewal and Fisher, (2018) stated that diabetes management goals can be achieved when treatment strategies and priorities are tailored to individual needs. It begins with the confident and careful diagnosis of diabetes. The measurement of blood glucose level and the symptoms such as unexplained weight loss, increased urine volume and thirst or marked glycosuria can be critical symptoms which indicates the diagnosis of the disease. The individuals who does not have these classical symptoms but which are high risk such as those with positive family history, obesity and elderly must also be subjected to diagnosis procedure. The timely and accurate diagnosis is vital for the effective management of disease. As per the view of Brooks and Chakera, (2019) along with the symptoms clinicians must also pay attention to the full history of patients. For this purpose factors such as cardiovascular complications, hypertension, obesity, smoking, family history, neuropathic complications must also be taken into account.

Treatment And Management Strategies

Wilmot, Hammond and Gregory, (2016) suggested treatment strategies of diabetes consist of three major components like dietary and life style changes, insulin treatment and oral hypoglycaemic therapy. Education is an integral element of the diabetes management which ensure that patient, health professionals and carers have adequate knowledge and skills to promote self care and for achieving desired health outcomes. The health leaders must encourage or motivate the vulnerable groups or patients to set therapeutic goals for controlling weight, blood sugar or blood pressure.

Goode and Hoover, (2018) stated that initial management of diabetes must be based upon combination of dietary therapy with physical activities (if possible). For the patients having presence of hyperglycaemia the pharmacologic therapies such as insulin or oral hypoglycaemic drugs must also be taken into account. It is also required that individuals and carers must have adequate knowledge of therapy targets, nutritional requirements, extent and type of physical activities, meal planning and life style improvements. The health professionals must also educate individuals regarding emergency and life threatening situations such as detection and management of complications like skin care or visionary issues, management of emergency situations like hypoglycaemia, self monitoring and actions against the results of self analysis.

According to Barnard and Breton, (2018) for the diabetes management of all target groups diet is foremost management aspect. The dietary treatment of the disease ensure that weight of the individual is control and their nutritional requirements are also fulfilled. Thus it is suggested that cholesterol consumption must be restricted or limited to only less than 300 mg on daily basis. The nutritive sweeteners and excessive salt intake must be restricted. The dietary control is not only advised for the diabetic population but is also suggested for the vulnerable groups who are higher risk of developing disease.

In similar context Hoppe, Cade and Carter, (2017) stated that for the non-diabetic population alcohol consumptions must also be restricted or limited. In response to the critical role of diet in diabetes management individual needs and dietary intake assessment must be done as an essential part of the initial management process. As leader nurses must have abilities to lead and work in collaboration with dieticians. In cases when dieticians are not present nurses can also work with physicians. Contrary to this Kong and Gregory, (2016) suggested that food intake and choice of people greatly depends upon local circumstances such as food availability, cultural and social values as well as economic factors. Health professionals must develop leadership attributes so that they can lead the health care team and dietary counselling can become a continuing process. The dietary consideration and meal planning becomes more crucial element of the management plan for diabetes patients. The health professionals must focus on even distribution of meal throughout the day, energy intake on routine basis and consistency of food timings.

Berry, Davies and Dempster, (2019) elucidated that physical activities not only encourages weight loss but also improve the sensitivity of insulin which lowers the level of blood glucose. As per the capability and requirement of person dietary treatment must also align with the exercise and physical activity programs. The people must also be informed about hypoglycaemia risk and strategies to eliminate its complications. In support to dietary and exercise management strategies Barnes and Harriss, (2018) believed that for quality health outcomes oral hypoglycaemia drugs must be considered only when combination of diet and physical exercise fails to achieve the targets of therapy. Patient must be made aware of signs and symptoms of diabetes at an early stage. In diabetes they might face problem of frequent urination. This can be because when blood sugar level is high, kidney tries to remove the excess of sugar by filtering it out through urine. So patients must be given education about this situation. This can support them in enhancing their health outcome. It has also been analysed that patient suffering from diabetes also faces problem of increased thrust. The frequent urination that is necessary to remove excess sugar from the blood can result in the body losing additional water

As per the view of Taylor and Barnes, (2019) a productive and efficient diabetes management requires high level of awareness. Thus it is necessary to control rise and fall of blood sugar level, weight and other aspects. Along with the dietary plan it is also required that individuals must be aware of the impact a particular type of food have on sugar level. In addition to the food type, the combination of food and quantity of different food is also crucial in regulation of blood sugar level. When clinicians works in team with dieticians they must give knowledge to patient regarding portion sizes and carbohydrate counting. The vulnerable groups who are suggested to manage weight must try to plan meal which has balanced components. It is the responsibility of the health professionals to ensure that t here is coordination between insulin or other diabetes medication and the diet taken so that sugar levels remains within normal range.

Goode and Hoover, (2018) believed that though physical activities are suggested by health professionals but these3 must be commenced with due care. Along with intensive work outs the light activities such as gardening, walking or being on feet for extended periods can also help to improve the sugar level. Thus the health professionals must not only focus on diet plan and medications but also provide a well formulated exercise plan to their patients. The number of sets for exercise, type of work out and exercise schedule must also be prepared in consultation with the health professionals.

In the same context Wisting and Snoek, (2019) stated that insulin and other medications are designed for reducing the blood sugar level when other management interventions are not sufficient. However the efficiency of medication plan also depends upon their quantity or dosage and timing. Diabetic patients must have precaution while taking other medications with insulin dosage. There must be a balance between meal plan and medication dosage. Along with the self control and monitoring from the patient, health service providers are also responsible for ensuring the safety and management of diabetes symptoms.

Diabetes management program bring significant changes to life style. Thus individuals are also required to make their life stress free. According to Preshaw and Bissett, (2019) practices such as smoking or drinking alcohols can worsen the symptoms of diabetes and can also encourage the complications of diabetes likes nephropathy. These changes can make individuals depressed and anxious. Hence for better care it is recommended that along with the physical symptoms diabetes management must also include psychological aspects such as depression so that individuals can cooperate and work together with health communities to manage the progression and symptoms of their diabetic condition. Effective diabetes management and prevention programs require support from individual, carers, health professionals and multidisciplinary team which can provide an integrated care to the diabetes vulnerable groups or patients.

Long Term Complications And Their Management

As per Barnard and Breton, (2018) the diabetes mellitus and its life threatening complications includes a wide range of issues. The key long term complications are related to eye or visionary issues, cardiovascular diseases as well as kidney issues. The diabetic retinopathy which is major cause of visual disability is encountered in less than 10 years of insulin dependent diabetes mellitus. The effective diabetes control can lower the probability of occurrence of retinopathy. The use of laser photocoagulation on timely diagnosis of retinopathy can be used to prevent severe visionary loss. The health professionals must refer regular assessment of diabetic patients so that retinopathy can be detected in the initial stages only. For this purpose retinal changes, cataract and glaucoma must be detected and treated at the earliest. The treatment must also emphasis on controlling blood pressure and glycaemia.

According to Sharma, Nazareth and Petersen, (2016) the prime cause of deaths associated with diabetes is due to diabetic nephropathy. It is significant reason of morbidity and high health care costs which can also lead to end stage renal issues demanding renal transplantation or dialysis. The progression of nephropathy can be slowed or prevented by strict glycaemic control, timely detection of infections, avoidance of nephrotoxic drugs and effective treatment plan for hypertension. Thus in addition to the dietary and medication control health professionals must also be refereed for assessment of protein levels and microalbuminuna in urine annually. The service providers and family members must not neglect the symptoms such as foot infections or early lesions.

Bird and Turner, (2016) elucidated that after nephropathy, the cardiovascular diseases (CVD) such as strokes, coronary heart diseases are also responsible for deaths among diabetic population. The screening of early signs for the CVD must be performed. The management plan must include activities which promote physical exercises, weight management interventions, correction of CVD risk factors and cessation of smoking and alcohol. The hypertension can also enhance the vulnerability and the severity of the diabetes risk factors.

PROJECT PLAN

Budget

The major expenses of the project will be in data collection and implementation of management strategies such as promotional events for increasing awareness about diabetes and to provide necessary support services to the patients. The total cost estimated for the project is £2000. This total project cost also includes cost for internet, secondary data sources like books, journals and printing costs.

Project Plan

To evaluate the learnings from the diabetes management project, plan-do-study-act (PDSA) model is used. Various stages of this model are as follows:

Plan: In this phase of project management strategies, purpose and objectives are planned. The outcomes will be measured in terms of number of patients, sugar level and other health parameters of the patients, cost reduction and reduced hospital admissions.

Do: In this stage project activities are implemented and activities are executed to manage the disease and health outcomes of the patients. An effective interaction is also made with the patients so that their issues can be resolved and needs can be fulfilled.

Study: In this stage outcomes are monitored and evaluated so that actual outcomes of the project are compared with planned target. The evaluation is also helpful to evaluate the various challenges which can affect the future stages or outcomes of the project.

Act: In the last phase of the project conclusions are made if integration of leadership and management approaches have succeeded in diabetes controlling or not. The stage also guides health professionals to analyse if patients needs are taken into account or not for the better health care service delivery.

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Gantt Chart

The total project duration is of 12 months. The Gantt chart below gives scheduling and description of various project related tasks.

Project Risk

The success of project may get affected by several risk factors which includes both organisational risks and project associated risks. The major risk factors identified for the study are as follows:

The patients may fail to understand the interventions for diabetes management delivered by project (Hoppe, Cade and Carter, 2017). Thus project outcomes and aim must be communicated effectively so that unnecessary project delays and confusion can be avoided. Poor management can lead to project failure so it is required that all resources must be managed properly with appropriate leadership.

Opportunities

The project will be helpful for both patients and health care professionals. The suitable leadership approach chosen by health service providers will lead to deliver quality health outcomes. The management of diabetes at the early stages is vital to reduce the number of new incidences of the disease (Simmons, Wenzel and Zgibor, 2016). The existing service users can also delay the adverse health outcomes by adopting suggested management strategies. The project is helpful for the health organizations to enhance the quality of services so that diabetes risk and vulnerabilities can be reduced to a significant extent.

DISCUSSION

Leadership Approach

Leadership has been termed as the most prominent factors for developing the organizational culture which is qualitative and increase the performance of employees working in health care unit. Leadership is an art that influences individuals to perform certain task, this when used in organization can support them in achieving their ultimate goals and objectives. It can also support growth of health care delivery system. In order to manage the change which has been implemented in health care unit, it requires skilled leaders who have the effective talent and abilities (Kumar Sharma, Singh and Matai, 2018). Effective leadership approach and right leadership style will initiate efficient team work that will be useful for managing patients suffering from diabetes mellitus in health care system. Various types of leadership style can be used like for example transformational, transactional, autocratic, laissez fair, task-oriented and relationship oriented leadership styles. Transformational leadership style is that method in which leaders are engaged in motivating and encouraging staff members to perform better and bring out innovative and creative ways to solve problems that is been existing in system.

This supports in growing and shaping the future success of health care system. In this type of leadership style, workers are also being given with the authority to make certain decisions, so that they can also stay motivated. In transactional leadership style leaders are engaged in acting as managers of change, motivating employees to bring new ideas so that there is being an improvement in production aspects. In this leadership style leaders promote compliance by rewarding and punishing workers. In this style staff members are only motivated for quiet sometime. This type of style is most successful when the problems existing in health care system are clearly defined and specified. It can be used in situation of crisis. Autocratic leadership style can be used when there arises a situation of emergency, in this leader dictates policies and procedures that needs to be followed by all the staff members (Yahaya and Ebrahim, 2016).

All decisions are made by leader itself without taking into account the thoughts of employees. Laissez faire leadership style is that in which leaders give free hand to their staff members to make any decision without involving them. Hands-off approach is used in this type of style that results in rare changes. Task oriented leadership style includes when leaders are engaged in giving the job to employees according to their skills and abilities. This can also enhance motivation among employees. It creates satisfaction among staff members. In this when roles and characteristics are being clear among workers then this can create employee's loyalty and also no chaos can exist in organization. Planning related to activities is also being done by leaders in this type of style (Nawaz and Khan, 2016). Relationship-oriented leadership approach is that in which the main focus of leaders is on well-being of employees. In this leaders are involved in making better terms with their workers so that they can easily analyse problems that is being faced by staff members. This can enhance the growth of health care system.

Different leadership style produces different health relate outcome, they can broaden or close the gap that may exist in health care system. Transactional leadership style can be used and be can be best suited to run this project. It will support health care unit in achieving their goals and objectives in most effective way. With short-term planning as part of this leadership style, management ensures that its visions for the company or organization will be realized. This leadership style consists of structure that is clearly defined, so no confusion can exist in system while following this leadership style. They make the goals more achievable by ensuring growth of health care system (Maak, Pless and Voegtlin, 2016). This leadership style is fully based on motivation and performance of employees. In this approach staff members are being rewarded if they perform better. Rewards can be in form of monetary and non-monetary. This brings short term motivation in workers to achieve their goals and objectives. Leaders in this type of style are more organized and action-oriented. They make sure that goals and objectives of system is being achieved by them on timely basis. Also they are engaged in motivating employees to provide high quality services. If staff members are effective in their working then leaders also make use of punishment, so that their work efficiency can be improves. Leader must make sure when they are implementing change in health care unit, staff members must be given proper training and made aware about the changes that is going to be implemented. This can support them in enhancing skills and also changes can be implemented easily. Leaders must also motivate employees to perform better so that their individual goals and objectives are also being achieved. They must make sure that change is effectively being communicated among them. This can also support them in making better relationship with workers, it will also create loyalty of workers.

Transactional leadership style motivates employees that directly increases the productivity of health care system and it also reduces the operational cost. Rewards when being used by leaders also enhances relationship between leaders and employees that also creates employee loyalty. In order to improve health care quality team work is also considered as most important factor. This type of leadership style will ensure that quality health care services are being delivered across the organization. Transactional leadership style can be best used when the gaols in organization are being cleared.

Change Management And Diabetes Mellitus

As it has been analysed that environment related to health care unit is changing rapidly and all the health care units are engaged in making use of updated technology and better computer assisted devices. Implementing change in health care unit is really critical and also the changes can be really difficult to be adopt. Motivating patients to make use of blood sugar meter to measure diabetes will be examined by using Kurt Lewin model of change. This model can help in analysing how changes can be effectively implemented. Lewin's theory can also be used in order to understand how alterations can impact the working of health care system. It will also help in analysing the barriers that are brings resistance to change. This model will also support in making employees and patients aware about that change is necessary and it will bring betterment to them.

Unfreezing: It is the first step towards implementing change. It involves motivating service users or patients to make use of blood sugar meter so that they can diagnose their diabetes at home only and they do not have to visits health care unit. The main focus is that all the change is being communicated to employees, stakeholders, NGO, hospital staff, government and hospital administration. In this step, the barriers which can be faced by health care unit in future will be identified and also it will be communicated to all staff members, so that they become aware about adopting these changes. It has been analysed that the most important factor by which change can be successfully implemented is that there is an open flow of communication. If there is no open communication between staff members and employees, then this can create conflict in firm.

Moving/change: This stage includes the planning and implementation process. Making patients use the home monitoring meter for measuring blood sugar level will require efforts from various teams like for example software developer, hospital staff administrators, program managers, clinical servants, health care professionals, patients, employees and many more. Support from all of them is really necessary for successful implementation of this plan. Also effective planning must be made between different stakeholders. Health care unit also must make sure that training is being provided to all staff members, so that they can make patient know clearly about the advantages that is being related to using blood sugar meter (Mak, and Chang, 2019). Also project leader must be engaged in analysing that there is an open flow of communication and role and responsibility of each staff members is being cleared. In this high quality training must be provided by health care unit to workers so that the use of blood sugar meter among patients can be increased.

Refreezing: It is the final stage of model, in this re-enforcing is being done. In this stage health care unit must make sure that support from all stakeholders is being given to them until the change is completely being implemented. As it is a really important step for successful implementation of change. They must also analyse that every staff member is comfortable with change that is being adopted. In this step a keen support is needed from hospital administration for the success of this project plan. When changes are being successfully adopted then hospital care unit must be involved in analysing future challenges, barriers and problems and finding out the ultimate solution for them. This can support their future growth and success.

Force Field Analysis

Force field analysis is that tool which can support health care system in improving the quality of services that is being provided by them. It will identify driving and restraining forces that support or work against project. This analysis can also support in understanding the resistance factors that can occur as barrier to change. To bring new change and more creative approach brain storming sessions can also be done, so that new ideas can be collected in order to successfully implement the change. In the project report, the barrier that can be faced while adopting use of blood sugar meter can be service user's resistance to use it. There might be chances that patients are unable to understand the use of blood sugar meter. Situation might occur when hospital setting is unable to update the technology and make them understand to their staff members. Increase in workload can also act as restraining forces that must be emphasize by the health care unit. For overcoming the barriers force field analysis emphasize that proper training is being provided to staff members so that changes are being implemented successfully (Cummings, Bridgman and Brown, 2016). This will also enhance skills of employees and also there will be no barrier towards change. The driving forces in this project report will be the availability of internet services, making blood sugar meter available to all patients, finance related requirement. Also to successfully implement the change it is really necessary that there is support from upper level staff members and resources must be utilize by them effectively so this can assist growth. It has also been analyzed that managing time can also act as driving force in project report. Hospital care setting must make sure that goals and objectives must be made clear so that proper time management can be done. It will help in overall success and future growth.

Project Outcome And Sucess Evaluation

The project is successful or not, this can be evaluated and measured with the help of questionnaires that can be filled by patients and staff members. Also the overall data analysis from time, cost and outcomes.

Patient: Safety of patients, there wellbeing and conveyance are the main aim of this project. Measurement of success in service users will be calculated by the less number of service users visiting the hospitals. The success of this project lies in improved outcomes during the type two diabetes and also the project will be counted as successful when service users are less anxious, depressed and stressed (Hussain and et.al., 2018). Also success can be measured by evaluating that patients are less stressed and trying to consult doctor on regular basis without compromising on their health conditions.

Staff members: This project will be counted as successful when staff members have less workload in health care unit. It can also be measured when they are being provided with safe and secure working conditions. Also it would be beneficial when staff members have more time to make other appointments as well. Also success can be measured when staff members are not leaving the hospital care setting on frequent basis and they have loyalty towards them.

Hospital administration: From the view point of hospital administration, success can be evaluated when they have more time to make better appointments with patients and also the appointment made by service users facing diabetes is being lowered down. Also the services users are being handled by them carefully and safely.

Government: From the perception of government success will be measured when service users have better health outcome and also when high quality service is being provided by health care unit. Also success can be measured when employee turnover is being reduced and feedback from staff members by workers is positive.

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Reflection

From the project outcomes I strongly believed that leaders play significant role in management of health care practices especially in chronic diseases such as diabetes. The selection of appropriate leadership strategies helps me to deliver care services in efficient, sustainable and appropriate manner (Hoppe, Cade and Carter, 2017). For becoming a good leaders, I must also develop management skills. I have also learned through my experience that circumstances of patients and health care delivery changes constantly. Thus to cope up with these situations and to deliver quality health care services I must also develop new skills such as communication and flexibility. For being a good leader I must also ensure that my team members are competent enough to understand the needs and objectives of diabetes management. The continuous learning and education programs can be valuable in accomplishing this goal.

In the role of health care leader, I must identify such barriers which act as key challenge in the service delivery. For this purpose, I can enhance interaction with the family members of patient so that their support can be used to improve the condition of patient. There are patients who does not have access to health care services or the approaches which can improve the service quality. However, as health professional leader it is my responsibility to identify those barriers and to motivate other team members so that collaborative working can assist them in addressing health requirements of the patients. The selection of appropriate leadership strategy is also vital for me to ensure the active engagement of other multidisciplinary teams and patients. My ineffective leadership skills can also result in failure to manage necessary resources for health care services. Thus diabetes management depends greatly to the health care leadership and management approaches (Simmons, Wenzel and Zgibor, 2016). In addition to this project has also helped me to analyse various challenges, responsibilities and strategies for becoming a good health care service leader.

Recommendation

It has been analysed from the report that health care unit must be engaged in evaluating the cost effectiveness of home monitoring blood sugar meter in patients suffering from type 2 diabetes needs to be performed. Service users must be realised that making use of this meter can support them in knowing about the early signs and symptoms so that disease could be managed and diagnosed at an early stage (Simmons, Wenzel and Zgibor, 2016). It will also reduce mortality rates among patients. Also more number of patients can be made aware at an early stage of disease. This can support them in improving their health related outcome. I will like to recommend to other individual who is going to make same project to prioritise the task according to its importance. It is being recommended by me that the project maker must get involved in doing intrinsic research so that better results can be obtained by them. They must involve more staff members and hospital administration as someone or the other will always have an idea to improve. I would recommend the project should not be started by individual while not having proper knowledge about the blood sugar meter. They must also make other learn about the use of blood sugar meter. In order for successful completion of project, I would recommend that individual must also take support from technical as well as hospital staff.

Conclusion

From the above report it has been summarised that controlling blood sugar level is one of the major goal of diabetes treatment. It has been analysed that type 1 diabetes can be managed while changing diet of patients. It can also be treated while exercising regularly and having a control over the insulin. Type 2 diabetes may be managed with non-insulin medications, insulin, weight reduction, or dietary changes. It has also been interpreted from report that in order to improve the health care service, various leadership approaches can be used. In this project transactional leadership approach has been utilised so that staff member's stays motivated and changes are being implemented firmly. In the report Kurt Lewin change management model has also been used so that no barriers occur while adopting changes. In order for successful implementation of change, health care unit must make sure that alterations are communicated properly to all staff members, hospital administration staff, government and NGO's. Support must also be taken from the patients. It has been analysed for motivating patients to use the blood sugar meter, they must be given proper education. They must be realised that this meter will help them in monitoring and analysing disease at an early stage. Also training must be given to staff members as the technology will be updated in health care system. It has also been analysed in report that there are various signs and symptoms which occur at initial stage like increase in thirst, frequent urination. So these signs must be made known to patients. This step can help them in improving their health outcome. It has also been analysed that by exercising regularly, patients can have a control over their diabetes. It is also recommended to them to stop consuming alcohol and smoking cigars, as it will help them in improving their health conditions.

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