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Main PostTransitioning from Closed to Open SystemsThe problem identified in this nurses' organization is the discharge process. The dischargeprocess is anessential part of patient safety and experience. The HCAP scores at the facility havestruggled in this area due tomultiple factors that affect discharge process and patient understanding. The goal of discharge process is to provideeducation and support to ensure the patient will be safe and stable outside the hospital environment (Augustinssonand Peterson,2015).In organizations, there are two types of system theories, closed and open. A closed system is more resistant tonew ideas. An open system interacts with the environment receiving ideas and building on these ideas to improve aprocess. Meyer & O'Brien-Pallas (2010) discussesthat the organization depends on its environment for thoughts to helpsustain and process these ideas to develop good outcomes.The closed system perspective does not take the whole picture of the organization into account. As a nurse completing the discharge process. The focus is to show the patient what to doafter leaving the hospital. The forethought of how their interactions and patients perceptions will affect the HCAP score is not always the firstpriority. Nursing is pressured to do the process better and faster for staffing and bed availability. Closed systemthoughts of a nurse leader are focused on the task at hand and not entertain new ways to approach the dischargeprocess.The hospital is considered an open system due to the interaction with other resources for growth.Approaching the discharge process in an open system would begin with looking at other hospitals doing well onthe HCAP discharge process question. Assessing their process, research
approaches to teaching such as teach-back. Marquis & Houston (2017) states change process happens when a few employees begin a conversation aboutthe dissatisfaction with the current handling of a process by leadership. In this discussion, the dissatisfaction iswith the current discharge process and the effects the process is having on the HCAP scores.Improving outcomes of the discharge process are, to begin with, nursing leadership and frontline staff havingtheconversation about the discharge process. Frontline staff needthe opportunity to express their concerns andthoughts on how to improve the process. Each person involved in the process needs to research ideas and bringback their results and decide how to improve the process. Once the process is decided, then the process to beginthe change is initiated. Training on the new ways to complete the discharge process and new policies are needed.Physician input into the discharge process is important. The physician starts the discharge by writing dischargeorders, having their thoughts on how to improve patient understanding can be valuable. Patients listen to thephysician more readily. Nursing reinforcing the physician's orders and incorporating this into the process ishelpful in the teach-back method. Reassessment of this change will be following the improvement of the HCAPscores and change parts of the process according to the scores reflection, feedback from patients.