There can be delays in accessing available interpreter equipment. Resources are not available in every language but are available in the most prevalent languages seen in AHWC. Charting & Documentation Copies of a patient’s chart can be requested 24 hours after the patient discharges from either the inpatient setting or the emergency department. Patients/family may not interact with the chart in real time. Patients/family are not able to chart or manipulate the patient’s chart. Care Support AHWC does not have visiting hours. Family and visitors are welcome 24 hours per day. Family/visitors are welcome to be present during rapid response or code activity. Patients/family do not participate in multidisciplinary walking rounds or shift report. Care Patients/family are active participants in developing the plan of care, as well as ongoing discharge planning/ care transition assessments. No weakness in this area. Area of Improvement One area of improvement can be the patient and family’s participation in shift report. Improvement Strategy
ORGANIZATIONAL LEADERSHIP 6 To implement changes to the handoff process can be done on all units at one time or unit by unit adjusting for differences in patient care areas. For the purpose of this assessment, the strategy for implementing this change will be one unit at a time starting in critical care areas and the emergency department, then progressive are units, surgical areas, and finally the medical surgical unit. In critical care areas and the emergency department the nurses are usually giving report on all their patients to the same nurse. By implementing the change in this manner leadership can gather data and improve processes more efficiently before implementing the change on progressive care units, medical units, and surgical units. Implementing this change on medical and surgical floor may come with resistance from the staff as it can be time consuming for nurses to do bedside report on 5-6 patients when there are multiple nurses to give report to. System or Change Theory - Lewin Lewin’s theory proposes that people are influenced by driving and restraining forces aimed at keeping the status quo (Sullivan, 2017). The strategies for change identified in this theory are “increasing driving forces, decreasing restraining forces, or both” (Sullivan, 2017. p 62). By using Lewin’s change theory, the process of implementing bedside shift reporting can be well planned, initiated, and evaluated for effectiveness. The change process identified by Lewin includes unfreezing, moving, and refreezing. Unfreezing is identification of a problem or need for change. In this step the problem or change can be discussed with administration and a plan for process improvement can be presented.
ORGANIZATIONAL LEADERSHIP 7 Moving is the implementation of the process to staff. This includes education of what bedside shift report is and how it is beneficial to the patient’s care. During this time the staff is given opportunities to voice concerns and provide feedback for process improvement.
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- Fall '17