daily operations of the unit. He coordinates all admissions into to unit with the house supervisor and the admitting physician. He strategically assigns patients rooms according to patient location, room availability, nursing skill mix, and patient diagnosis. He is responsible for creating the shift assignments, floating staff between units and the floor, knowing their seniority status for floating, ensuring that the safe delivery of high-quality care is given to each patient by the nurses, how and when to intervene in unsafe situations and advocating for all patients and staff members. He performs annual evaluations, coaching, and counseling, he stays abreast of the changes and relays them to staff during huddles, maintains the departmental staffing budget, ensures policies and procedures are being followed, and interviews and hires new staff members. He performs nightly patient rounding, direct reports with staff, audits, collaborates with the multidisciplinary team to downgrade patients to a lower level of care, responds to all code blues, and he stays abreast of and implements best practices across the continuum. There is a plethora of other duties that the ANM performs and he remains to be a vital component of the leadership team.
Essentials of Advanced Nursing Practice 8 A5. Characteristics of the Organization Kaiser Permanente is recognized as one of America’s leading health care providers and health insurance plans and is one of the largest not-for-profit organizations in the United States. Each Medical Group is operated as a separate for-profit partnership or professional corporation in its territory, and while none publicly reports its financial results, each is primarily funded by reimbursements from its respective regional Kaiser Foundation Health Plan entity. Its high-quality patient care has been highly rated and attributed to a strong emphasis on preventive care, its doctors being salaried rather than paid on a fee-for-service basis, and an attempt to minimize the time patients spend in high-cost hospitals by carefully planning their stay. KPSF also serves the largest population of members for gender reassignment surgery. Before recruiting the expert microvascular surgeon, Dr. Ali Salim, KPSF sent their members to other hospitals for the procedure (The Permanente Medical Group, 2019). However, Kaiser is not without blemish. It has had disputes with its employees' unions, repeatedly faced civil and criminal charges for falsification of records and patient dumping, faced action by regulators over the quality of care it provided, especially to patients with mental health issues, and has faced criticism from activists and action from regulators over the size of its cash reserves (Jaffe, 2006). The hospital is also very busy with procedures, surgeries, admissions, transfers, and discharges. The business tends to cause problems with an adequate understanding of patient care. According to recent HCAHP scores, 50% of patients have reported not fully understanding their care upon discharging from the hospital (U.S. Center for Medicare &
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