Changes in health care based on consultation Recommendation
Change management is one of the most important things in health care today. Because the healthcare environment is getting more complicated, people who work in it need to learn skills and know-how to handle change well. For example, the person in charge of change should know a lot about how technology is changing, what rules need to be followed, and the need to improve efficiency. Nurse leaders are some of the most important people in analyzing, planning, and carrying out operations that can make healthcare safer and better. When planning for change, you need to do a process study to find out which parts are working well and which ones need to be fixed. The main goal of this discussion is to look at the role of the nurse leader in changing a certain healthcare company.
Why and an Overview
As a nursing consultant, I was asked to look at a health care company to see if there was something that needed to be changed or made better. The goal of the consultation was to find out the organization’s strengths and flaws with the help of a nurse leader. Also, the information gathered was used to suggest a change in practice that could help the group fix the weakness that had been found.
Change in healthcare is important because it makes services easier to get, lowers prices, and makes it easier to coordinate care. Change management can help the healthcare business deal with new technologies and the complicated needs of patient populations. (Salmond & Echevarria, 2017) New data shows that fragmentation, access problems, healthcare disparities, and less-than-ideal outcomes are the driving forces behind healthcare change. The nurses are not left behind in the process of change because they are educated, respected, and play a big part in managing the health care sector.
Because they have power and influence, nurse leaders are in a better situation to affect organizational change. I chose the clinical nurse educator for the meeting because of these things. Nurse educators are leaders, and one of their jobs is to come up with policies and procedures that can bring about change in a company. The first step was to send an email to the nurse boss to ask for permission to do the interview. After my request was approved, a face-to-face meeting was set up to talk about the jobs of the nurse leader and find out what the organization’s strengths and weaknesses are. Using structured questions, the discussion focused on the performance of the company, the roles of nurse leaders, and the use of evidence-based practices and projects to improve quality. Aside from the nurse educator, the organization’s website and the Medicare.gov Hospital Compare website were also good places to find out about the facility. The information gathered was used to suggest a change that could improve the way healthcare is given, including the standard of care and the safety of patients.
Description of the Group
The Cleveland Clinic is a non-profit academic medical center in Weston, Broward County, Florida. It offers high-quality care to the people it serves. The organization’s goal is to care for life, study health, and teach those it helps (Cleveland Clinic, 2021). The company wants to be the best place for care anywhere and the best place to work in health care. The organization cares a lot about giving its customers good care, which is why it has so many employees. The institution has more than 205 doctors who are experts in more than 55 areas of care to make sure that all groups are treated well. Because of the high standard of its services, the Cleveland Clinic is the best in the Miami-Fort Lauderdale area and one of the best in Florida as a whole.
Cleveland Clinic has become the best place to work by putting the community, healthcare workers, patients, and the company at the top of its list of priorities. The center is always open for both inpatient and outpatient care. Cleveland has almost 60,000 health care workers who care for about 883,839 people every year (Cleveland Clinic, 2021). Because there are so many different parts to the building, it can hold 1,300 inpatient beds and 6,026 people as a whole. The organization offers a wide range of health care services, such as emergency care, gynecology, imaging services, orthopedic surgery, endocrinology, and plastic surgery.
Patients from all over Broward County come to the Cleveland Clinic for health care services. The nurse leader didn’t know much about the people she helped, but demographic information could be found on the US Census Bureau website. The United States Census Bureau reports that there are 1,952,778 people living in the county as of 2019. Most of the people in the area are in their 30s or 40s, and the fewest of them are over 65. When it comes to race, most of the people who go to the hospital for health care are white. Statistics from the area show that white people make up 63.2% of the overall population, while black people make up 30.1% (United States Census Bureau, 2019).
The nurse trainer was able to explain the organization’s structure, which shows that the CEO is in charge of the most important decisions. The administrative unit of the building is made up of the CEO, his deputy, and the chief administrator. The nursing, medicine, finance, and human resources departments are under the management. Each of these departments is led by a chief officer. Other than nursing, no information was given about the different parts of the other areas. The nurse educator said that the nursing department is run by the chief nursing officer and the director of nursing services. The nursing supervisor, nursing educator, and nurse managers in the different nursing areas work under the director.
Most important needs of people
A health needs assessment uses a methodical approach to find out how healthy a community is and what its health care needs are. Sometimes, the health needs of individual outpatients can be a good indicator of the health needs of the society as a whole. According to the nurse trainer who was interviewed, most people who go to the doctor have long-term illnesses like diabetes, heart disease, obesity, and some types of cancer. The nurse educator also talked about teen health problems, such as the recent rise in sexually transmitted diseases in the facility. Because of this knowledge, more research was done on the prevalence of chronic diseases in the area as well as teen health problems like sexually transmitted infections, teen pregnancy, and drug abuse disorders.
Heart disease is the top cause of death in the United States. It is responsible for about one out of every four deaths in hospitals and nursing homes. The most common is coronary heart disease, which kills more men than it does women. Broward county has the same health care problem as other places, which is why about 3600 people die there every year (Florida Department of Health, 2020). Heart disease is the top cause of death for both Whites and African Americans in Broward county and the US as a whole, according to statistics. Most of the people who have this problem are older, and only a small number of people in their 20s and 30s have it.
Teen health and school health have been in the news lately because young people are taking more risks, which is bad for their health. For example, the CDC Young Risk Behavior Surveillance System (YRBSS) lists the six most common reasons of death among young people. Some of these reasons are sexual violence, irresponsible sexual behavior that leads to STDs and pregnancy, drinking and drug use, smoking, eating unhealthy foods, and not getting enough exercise. The Florida Department of Health says that Broward county has a lot of STIs, especially syphilis and chlamydia. Most people think that the high rate of drug and alcohol abuse is the main cause of these problems. Today, the focus is on the lack of sexual education. There are differences among the people who are impacted, with African Americans having the highest death rates.
Disease does put a lot of stress on the person, their family, and the whole society. Some of the health problems that have been found are chronic diseases, sexually transmitted infections, drug abuse, and violence. All of these problems cost a lot of money and affect the whole society. For example, (Maresova et al., 2019) chronic diseases account for 86% of all medical costs in the United States. The people in the community have to help pay for the care of these cases. Second, because so many people are sick, there is less work getting done. People are less productive when they miss work days or don’t finish chores because they are sick or on sick leave. When these diseases affect leaders and project managers, it has a big effect on community growth. Lastly, the cost of health care for families and groups goes up every year because more people are getting sick. A lot of time is spent at home and in the hospital taking care of old people with long-term illnesses. This leaves less time to focus on the young people.
Nurse Leader’s Roles
The nurse leader who was questioned was a nurse educator with advanced practice. As a leader in the group, the nurse is responsible for making sure that other nurses and students follow the rules. For example, nurses should keep learning and getting better at what they do through CMEs and other training programs. The nurse educator said that she always makes sure these rules are followed. The nurse educator also said that it was her job to make sure that nurses practiced in a way that matched their skills. As the institution’s head of education and training, the nurse emphasized that she knew how to write and create courses to meet the education needs of other medical staff.
Clinical nurse educators work as advocates for their patients and for the nursing profession, just like other advanced nurse practitioners do. The nurse educator said that she is very involved in professional groups and workshops, where she talks about policy and how to improve quality. As a researcher, the nurse educator talked about how good she was at making projects to improve quality by using the latest study evidence. Aside from these official jobs, she said, she also helps nurses with their schooling and work-related problems. As a leader, she sets a good example for less experienced staff and helps both experienced and new nurses learn the ropes.
The American Association of Colleges of Nursing (AACN) made a list of what every RN should know and be able to do when they graduate. This list is called the “essentials of baccalaureate education for professional nursing practice.” In different ways, the roles that the nurse educator talks about match up with elements III, VII, and IX. Essential is about improving quality and making sure people are safe. The nurse must be able to explain the methods, tools, performance measures, and standards related to quality, and she must also be ready to put quality principles to use in a company (AACN, 2011). As was said above, the nurse educator helps improve quality by teaching and doing study. Second, essential VII says that the nurse must be a part of and lead mixed teams that talk to each other and work together while giving care (AACN, 2011). To fit this job, the nurse educator said that she works with patients and other nurses to figure out where they are weak. The nurse also works with others to improve the facility’s standard through projects. Lastly, the jobs of the nurse educator are in line with essential IX, which says that the nurse needs a Master’s degree to do her job. The nurse educator showed that she was right for this job by taking part in making policies, advocating for them, and doing her job well.
Features of an Organization
During the conversation with the nurse educator, I was able to find out what Cleveland Clinic does well and what it could do better. First, the nurse educator said that the key to success in the hospital was the organization’s leadership. The group has a great reputation and has made a strong cultural connection with the people in the neighborhood. Because of these things, the organization is number one in the country when it comes to offering specialty care for adults. The nurse educator also said that the hospital has been able to add new services that help ICU, emergency room, and gastroenterology patients get the care they need.
One of the problems that the nurse leader has found is that there is no plan for releasing patients whose scores were not good. (U.S. Centers for Medicare and Medicaid Services (CMS), n.d.) Hospital Compare statistics shows that this question got a score of 57%, which is the lowest of the ten questions. In terms of quality improvement projects and the use of evidence-based practice (EBP), the nurse educator was able to find an ongoing project in the emergency room that used debriefing and briefing meetings. This project is meant to help nursing students learn how to deal with bad things that happen, especially after a death in the department. A briefing is a short meeting between people on a healthcare team to make sure everyone knows what is expected of them and what their job is. (Agency for Healthcare Research and Quality (AHRQ), 2019) Briefing meetings in the emergency room help to make sure that patient care services are better coordinated, that the direction is clear, and that there is a culture of open communication. On the other hand, debriefing happens at the end of meetings and is done by everyone on the healthcare team. Debriefs are used to improve communication, improve habits, and help healthcare workers who are too busy to do everything they need to do, especially when something important happens.
In the last few decades, using methods that are backed by evidence has become an important part of giving great care to patients. Uhm et al. (2019) say that evidence-based practice is the use of research, clinical knowledge, and patient preferences to guide the delivery of care. The group has found that using the situation-background-assessment-recommendation (SBAR) communication tool to improve shift handoffs between nursing teams is one of the evidence-based practices. This approach is thought to improve the continuity of care for patients by encouraging the sharing of information, keeping track of patient data, and getting the patient and family involved in making care plans (Uhm et al., 2019). This evidence-based program is meant to improve the quality of care, especially by lowering the number of medication mistakes and the costs of care that come with them. Also, the use of SBAR communication in the hospital during handoffs is meant to encourage care for patients that is coordinated and done in a collaborative way.
Changes to the organization are suggested
Even though patient education is the main way that many organizations get patients out of the hospital, knowing care after leaving the hospital depends on a number of other factors. It’s clear that there’s a need to come up with plans for how to get people out of the building days before they actually leave. In this case, I think the change that should be made is to make a proactive plan that includes planning the patient’s discharge on time, telling them about the process well, and giving them a release checklist.
Why it’s suggested to make a change
It is known that getting patients out of acute care facilities is hard, and that education is the most usual way to do it. Even when they are well-informed (Emes et al., 2018), there is evidence that many patients do not understand their care when they leave the hospital. For example, most people who need in-patient care are older, and schooling is less likely to change how they understand care if their family isn’t there. The way that is suggested will make sure that planning for the patient’s exit starts as soon as they are admitted. The patient should be told about and go over the plan for leaving the hospital every day until the last day. During this time, the patient’s care team will go over the most important facts about their situation and what they need to do before leaving the facility. Lastly, a discharge checklist will make sure that the patient gets all of the care they need, including information, before they leave the building (Emes et al., 2018). I think this method will help the patient understand care, such as how to follow instructions after leaving the hospital, so that they don’t have to go back.
Measures to Evaluate
The HCAHPS scores from hospital compare will be used as a national standard to measure how well the new change works. At the moment, the answer to the poll question “Patients who “strongly agree” they understood their care when they left the hospital” is 57%, which is higher than the state average (51%), but lower than the national average (54%). When the new change is put into place, the results should slowly get better in the facility. If the numbers get better, the hospital will make it a rule that all patients on all units must use the new discharge plan. If the HCAHPS results don’t get better, the new plan will be reevaluated, and more changes will be made to make sure the problem area is fixed.
Agency for Healthcare Research and Quality. (2019). Debriefing for clinical learning. https://psnet.ahrq.gov/primer/debriefing-clinical-learning
American Association of College of Nursing (AACN). (2011). The essentials of master’s education in nursing. http://www.aacnnursing.org/portals/42/publications/mastersessentials11.pdf
Cleveland Clinic. (2020). About Cleveland Clinic: Cleveland Clinic overview. Retrieved from https://my.clevelandclinic.org/about/overview
Emes, M., Smith, S., Ward, S., & Smith, A. (2018). Improving the patient discharge process: Implementing actions derived from a soft systems methodology study. Health Systems (Basingstoke, England), 8(2), 117–133. https://doi.org/10.1080/20476965.2018.1524405
Florida Department of Health. (2020). Broward County: data and statistics. http://broward.floridahealth.gov/programs-and-services/community-health-planning-and-statistics/data-and-statistics/index.html
Maresova, P., Javanmardi, E., Barakovic, S., Husic, J. B., Tomsone, S., Krejcar, O., & Kuca, K. (2019). Consequences of chronic diseases and other limitations associated with old age–a scoping review. BMC Public Health, 19(1), 1-17. https://doi.org/10.1186/s12889-019-7762-5
Uhm, J. Y., Ko, Y., & Kim, S. (2019). Implementation of an SBAR communication program based on experiential learning theory in a pediatric nursing practicum: A quasi-experimental study. Nurse Education Today, 80, 78–84. https://doi.org/10.1016/j.nedt.2019.05.034
- S Centers for Medicare and Medicaid Services (n.d.). Cleveland Clinic Hospital: Patient survey rating. https://www.medicare.gov/care-compare/details/hospital/100289?id=c829a7e5-253e-4bd8-976c-07b0691771bf&city=Pembroke%20Pines&state=FL&zipcode=33082
Salmond, S. W., & Echevarria, M. (2017). Healthcare transformation and changing roles for nursing. Orthopedic Nursing, 36(1), 12–25. https://doi.org/10.1097/NOR.0000000000000308
United States Census Bureau. (2019).Quick facts: Broward County, Florida. https://www.census.gov/quickfacts/browardcountyflorida
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