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Unformatted text preview: Running head: ORGANIZATIONAL LEADERSHIP AND INTERPROFESSIONAL Organizational Leadership and Interprofessional Team Development Rebecca Onyirioha Western Governors University 1 ORGANIZATIONAL LEADERSHIP AND INTERPROFESSIONAL Table of Contents References..........................................................................................................................17 2 ORGANIZATIONAL LEADERSHIP AND INTERPROFESSIONAL 3 Organizational Leadership and Interprofessional Team Development Business Practices Every business is created to make money. Hospitals are not an exception from this endeavor. For hospitals, most of the funding is through reimbursement from Centers for Medicaid and Medicare Services. Quality standards must be performed to help the hospital meet the criteria for such reimbursements. If these guidelines are not met for these topics, hospitals often do not get the government insurance reimbursements for their patients’ care and possibly entire stay. Policies and procedures are put into place for this exact reason. These policies and procedures ensure that the hospital’s staff members are providing safe and quality care that is satisfactory for the insurers. Organizations like the Joint Commission and the DNV are contracted to audit these hospitals practices. This will ensure that hospitals’ policies and procedures are in place and are being followed. Patient centered care is being improved as the hospital updates their policies and procedure to better their Hospital Consumer Assessment of Healthcare Providers and Systems scores. These scores are generated by the patient population that gets a survey about their recent care in the hospital. These ratings that are provided by these HCAHPS scores contribute largely to the reimbursement to the hospital from the CMS. Patients seeking hospital care can view these public scores and choose which facility and even provider they want to receive care from. HCAHPS scores are also being viewed by the private insurance companies who are possibly going to use these scores and core measures to adjust and alter their reimbursement processes. This impacts patient centered care by making it a high priority for healthcare organizations to provide the best quality care as well as meeting the benchmarks for safety and quality care. ORGANIZATIONAL LEADERSHIP AND INTERPROFESSIONAL 4 B. Patient and Family Centered Care Tool (PFCC) Please see attached document for completed PFCC Tool. B1. Setting Description The setting for this PFCC tool is a women’s health care center located in a hospital within a 691-bed teaching hospital. The women’s health center was added on the hospital in 2012. This wing includes Labor & Delivery unit, antepartum unit, Birth Care unit, level III NICU, GYN unit and a women’s medical/surgical unit. L&D performs about 200 to 300 deliveries per month and has 2 surgical suites and a 3-bed PACU. Antepartum is a 25-bed unit, Birth Care has 45 beds and there are 16 beds in the women’s medical/surgical unit. This women’s center serves a diverse patient population, from the homeless population, Medicaid/Medicare population to the private insurance holders. Patients being treated at this facility are typically in the higher-risk category. Patients from all over get transferred in to this hospital due to their higher acuity and need for the increased level of care. Due to the proximity of the largest homeless population in this particular city, comorbidities are quite common. B2. Strengths and Weakness of the Organization Table 1 DOMAIN STRENGTH Leadership/Operations The facility requires the managers and clinical leads of each unit to round on their patients daily. The patients are asked certain questions about their care from the managers and then they can provide feedback to the nurse manager. They also allow the patients and their family members to ask questions, voice concerns or give WEAKNESS Currently, patient and their family members have not and are not included in the meeting where they review and write the policy and procedures. ORGANIZATIONAL LEADERSHIP AND INTERPROFESSIONAL input on how their care can be bettered. Mission, Vision, Values The patients receive a welcome packet with a pamphlet containing their rights and responsibilities as patients. They also receive contact information on where they can find more information available, where they can report a problem, and how they can include their family in their care as a legal/support representative. The facility’s mission statement Advisors None. There was not any information provided where I could find a patient or family member that served on their advisory councils, hospital committees or participating in quality and safety rounds. Quality Improvement Team leaders and/or managers Patients and families are not interview the patients and families when they perform their walkrounds. Personnel No strengths identified. does not provide anything that specifically states that it is a patient and family centered facility. currently involved in the QI meetings and they have very little involvement in the quality improvement goals or implementation. Currently the patients 5 ORGANIZATIONAL LEADERSHIP AND INTERPROFESSIONAL and their families are not able to participate in the interviewing process for new hires nor are they involved in the orientation of staff. Neither the performance appraisal procedure or the job description includes the PFCC. The facility’s administration and physicians could better support the practice of PFCC. Environment & Design No strengths identified. Clinical projects currently do not have patients and family participating. Family participation in the collaboration of such things are very minimal. The patients and family members are not included when it comes to the clinical design projects. Information/Education Patients can access their care plans, lab work, tests, as well as their progress notes and records that were done each stay via web portals within 24 hours after being discharged. A patient or the family can communicate through messenger on this portal where they can ask questions, get refills Patients and their family members do not have direct email access to their clinicians. The resource rooms are limited to staff only. 6 ORGANIZATIONAL LEADERSHIP AND INTERPROFESSIONAL on their prescriptions, and even request referrals. Diversity/Disparities When the patient comes to the hospital, they go through registration. At this time, the registrar collects the patient’s diversity information. This information allows the care takers the information needed to help the patient be provided with an interpreter or a language line if requested. Education and information is given at the 5th grade reading and comprehension level unless the patient assessed has special needs for comprehension. Charting and Documentation Care Support The patient portal allows the patient the access of their electronic records. The patient’s family and friends are welcome to be at the bedside on most units 24/7. They are also included in bedside shift report if the patient allows them to be present. Patients have a medication The patients that speak less common languages do not always have printed material available for their education or instructions. Not every language is readily available on the language line which can cause some confusion with the patient or cause the patient to use family or friends to interpret for them. The patient’s official hospital records are only obtained upon request to the medical records department. This will cost a fee per page. Patients and their families cannot chart on their chart. During emergent situations, the patient nor their family can activate the rapid response. Also, during this time, the 7 ORGANIZATIONAL LEADERSHIP AND INTERPROFESSIONAL Care reconciliation at each visit. Upon discharge the patient is given this med rec with the updated time of when they last received their medication as well as their newly ordered medications. family is typically asked to step outside the room as the team work on the patient. The clinicians include the patients None. 8 and family members when making and setting goals. The clinician uses a “white board” located in the patient’s room each day where the goals are visibly written when made. The patients and family members are truly apart of the care team by helping set goals and they also feel listened to by the clinicians. Upon every round by the clinician, pain is addressed. If the patient’s pain is not being properly managed, the physician is notified each time. C. Area of Improvement This facility could use improvement in the area of Quality Improvement. Patients and family members should be included in the risk, safety and quality meetings and serve on these committees for their projects. Several of these meetings are held throughout each year and the patients and family are not included. By inviting patients and family to come and participate in these meetings, this facility could be encouraged and strengthened by gaining a new perspective from their input. If this facility could permit a few patients or family members serve on a project, ORGANIZATIONAL LEADERSHIP AND INTERPROFESSIONAL 9 it could provide the facility with a new perspective. This could help them make a better educated decision for further quality and safety projects on the allowance of patients and family members. C1. Improvement Strategy A strategy for improvement that could be tested out for this particular facility would include an invitation to a few select patients and/or family members of patients to participate in the risk, quality and safety meetings. A team should be built as the next step and they will oversee implementing the change that is needed for quality improvement project. Members of the team would be made up of patients or their family members. They will represent our patient population and be the voice for the population as they work on the project. A patient-centered care environment will be created due to the combination of the patient and family working side by side with the planning project committee. The patients and family members that serve on this project will add a different perspective to the committee. This newly formed team will then create a goal together and work on a plan on the recruitment of patient and family members for different projects. They will work on the implementation of the plan and determine how to measure if the plan is being successful. When the plan is ready to be implemented, the results can be studied. This will allow the group to see if the plan needs to be re-worked, discarded or if the plan is so successful, this new change could be adopted for further projects. C1a. System or Change Theory Lewin’s Change Theory is the change theory that could be used in this situation. The project team, made up of inter-disciplinary team members, will need to be formed. Members of the team will include a team leader, a patient or a family member representative, HR representative, QI representative and clinical staff. This group would then create a plan which includes having the patient or family member being included in al the meetings hosted. The team ORGANIZATIONAL LEADERSHIP AND INTERPROFESSIONAL 10 would use all their input and information, along with the patient/family member’s ideas and input during their planning for future projects. Unfreezing the known behavior and changing the status quo is Lewin’s first step in his process of change (Kritsonis, 2004-2005). The unfreezing would be where the team begins to introduce the change that includes the patient/family members to be on their committees. This new standard would be presented to all the staff allowing them to know about the newest addition to the systems quality, safety and risk meeting team. This will allow the staff time to change and correct their old ways of thinking and prepare them for the acceptance of the new change. Lewin’s second step to his change theory is the change itself or also known as “movement” (Kritsonis, 2004-2005). The patient or family member will now be attending the meetings, as well as giving their feedback on the improvement of this facility to help increase their focus on patient-centered care in the areas of safety, risk and quality. Refreezing is Lewin’s last step in his change theory which is where the change has now been in place for some time and has begun to stick, allowing it to become the facility’s new normal (Kritsonis, 2004-2005). When the patient or family member is no longer viewed as out of place and is now being accepted by all the other team members, that is when the change has become successful. If this new team continues with time and decides this change is no longer providing the facility with the patient-centered care as desired, then the change can be reviewed and can be modified or even reversed if needed. C2. Financial Implications Financial implications that the strategy may have on the organization would include the cost of the team members time at meetings along with researching and the evaluation process. There would be some possible initial cost gathering the patients or their family members and getting them to be involved with the interdisciplinary team. If educational materials are required ORGANIZATIONAL LEADERSHIP AND INTERPROFESSIONAL 11 in the communication process with the facility’s staff regarding the change of allowing the patients and family members to be on the team, this could have an initial cost. The hospital’s HR department will have to run background checks on the patients and family members as well as interview these participants which will cost time and background check expenses. If the hospital decided to compensate the participants for their time, this would create a cost. Having these patients or family members become part of the quality, safety and risk committee teams, will improve the facility’s patient experience and their outcomes. This beneficial addition to the team will enhance patient and family-centered care which will far exceed the costs of this implementation. Due to shorter patient hospital stays, improved work environment, safer work environment and better patient outcomes, the hospital will be saving money in the long run. C3. Methods A survey will be used as a method of evaluation on effectiveness of this new implementation. This survey will be given to patients and family members before and after the implementation. It will provide information about their likes, dislikes, concerns and any other comments they may have to provide feedback for change and growth. There will also be staff and patient satisfaction surveys given before and after the implementation as well. The team will review the HCAHP scores from both before and after the implementation to help evaluate whether the strategy is being successful or needs to be further reviewed or even changed. Table 2 Team Member Role on the Team Team Leader The team leader will be in charge of setting the meeting dates and times. They will prepare the team’s topics of discussion and will make sure the team stays on topic. They will be ORGANIZATIONAL LEADERSHIP AND INTERPROFESSIONAL the delegator of tasks, as well as inform administration of the team’s progress. The team leader will motivate the members, maintain progression by meeting their goals and help create a healthy working environment for the team members. Patient/Famil The patient/family member will be the y member representative for their community. They will use their personal experience to help provide useful information to help form ideas on how to improve the organization. Clinical Staff The clinical staff will include a manager, floor nurses from different areas and nurse aides. They are the eyes for the floors and will help the team by planning and implementing new change. They will work side by side with their patients and family members to help their team get a greater idea of what the patients and family members are currently feeling and experiencing in their care. Quality Quality Improvement staff will be responsible for Improvement collecting data and information from the patients, family members and staff before and after the new implementation of change. They will be responsible in monitoring quality improvement reports even after the implementation is in process and continue to monitor that the change is still functioning properly. Human Human Resources will be in charge of the Resources interviewing process of the patients and family members that will be a part of the project team and meetings for the new process. D1. Team Diversity 12 ORGANIZATIONAL LEADERSHIP AND INTERPROFESSIONAL 13 Having diversity on the team will provide the facility with better culturally competent care and staff members. This will support patient-centered care culturally because it will allow different types of staff members to have the opportunity to work on a project together. Their experience levels, roles, skill sets, personalities, ethnic views, and knowledge levels will all be represented in these meetings. The patients will be better served by a group of culturally diverse staff members, as well as policies. A cultural diversified organization has shown to provide improved increased patient satisfaction and quality of care (Roussel, 2013). When a team is created with different backgrounds their ideas can spark new ideas in each other due to different ways of thinking. Multiple views on problem solving as a team will better the group and the patient centered care for the organization. D2. Leadership Theory Transformational leadership is the type of leadership that will be used to guide the team. Transformational leadership allows the members of the group to feel empowered instead of punished or manipulated. It creates an environment for the team to feel valued for their collaboration instead of feeling they are competing with one another. This leadership style will encourage the members to be leaders as well and to bring their ideas to action to achieve their goals. “Transformational leadership and innovative approaches are needed for change in health care and are critical to successful organizational outcomes.” (Roussel, 2016, Chapter 2) D3. Implementation of Strategy There are several steps to implement a strategy. The first step would be to identify the organizations weaknesses using the PFCC tool, as well as reviewing patient satisfaction scores from the current quarter. Once the team chooses an element to improve upon, such as including patients and family members in the quality, safety and risk meetings, the second step would ORGANIZATIONAL LEADERSHIP AND INTERPROFESSIONAL 14 include that the team leader would start recruiting members for the group. Once the hospital team is formed, they will have to create a job title and description for HR to start recruiting the patients and family members that will represent the community as they serve on the team. HR will need to choose the most recent patients or family members that were in the hospital to make sure that the input provided is what the staff is currently practicing. The next step would provide that HR would have the patients or family members fill out surveys about their previous experience in this facility and then the project team would meet together to choose the best candidates for the project. After the patients and/or family members have been chosen, then all the members of the team will meet and start forming goals, plans and evaluation methods with outcomes that are measurable. The team leader will be the organizer of the meeting and will lead the meeting. The patients and/or family members will be there to share their experiences and give their ideas and input to better patient-centered care. The clinical staff will be able to provide the team with their views and input on how things are g...
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