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Assessment 3 Strategic Visioning With Stakeholders Details Attempt 1 Evaluated Attempt 2 Evaluated Attempt 3 Available Overview Prepare a 10–20-slide presentation of the strategic plan you developed in Assessment 2, to be delivered to key stakeholders at a strategic visioning session. Note: Each assessment in this course builds on the work you completed in the previous assessment. Therefore, you must complete the assessments in this course in the order in which they are presented. SHOW LESS Questions to Consider As you prepare to complete this assessment, you may want to think about other related issues to deepen your understanding or broaden your viewpoint. You are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community. Note that these questions are for your own development and exploration and do not need to be completed or submitted as part of your assessment. Reflect on the current cultural climate in your care setting. What aspects of the current cultural climate would aid in achieving one or more specific goals contained in your strategic plan? What aspects of the current cultural climate would present a challenge in achieving one or more specific goals contained in your strategic plan? What leadership theories, models, or strategies could help you turn this challenge into an opportunity? Effectively communicating with internal and external stakeholders and constituencies can help in achieving strategic initiatives. How would you communicate the essential aspects of the strategic plan you developed in Assessment 2 to stakeholders or groups, both internal and external to your care setting? Resources Suggested Resources The resources provided here are optional. You may use other resources of your choice to prepare for this assessment; however, you will need to ensure that they are appropriate, credible, and valid. The MSN-FP6210: Leadership and Management for Nurse Executives Library Guide can help direct your research, and the Supplemental Resources and Research Resources, both linked from the left navigation menu in your courseroom, provide additional resources to help support you. Change Leadership Kash, B. A., Spaulding, A., Johnson, C. E., Gamm, L., & Hulefeld, M. F. (2014). Success factors for strategic change initiatives: A qualitative study of healthcare administrators' perspectives. Journal of Healthcare Management, 59(1), 65–81. Mitchell, G. (2013). Selecting the best theory to implement planned change. Nursing Management (through 2013), 20(1), 32–37. Toussaint, J. S., & Berry, L. L. (2013). The promise of lean in health care. Mayo Clinic Proceedings, 88(1), 74–82. This article provides useful information for health care leaders who are considering a lean approach to quality improvement. Trajkovski, S., Schmied, V., Vickers, M., & Jackson, D. (2013). Using appreciative inquiry to transform health care. Contemporary Nurse: A Journal for the Australian Nursing Profession, 45(1), 95–100. Tropello, P. D., & DeFazio, J. (2014). Servant leadership in nursing administration and academia shaping future generations of nurses and interdisciplinary team providers to transform healthcare delivery. Nurse Leader, 12(6), 59–61. This article discusses how servant leadership and AI can be employed to effect transformational change in heath care. Tying Strategic Planning to Vision and Mission | Transcript. Nursing Leadership: Present and Future Needs | Transcript. SHOW LESS Assessment Instructions Note: In this assessment, you will develop a presentation to stakeholders for the strategic plan you developed in Assessment 2. Preparation Your strategic plan has been reviewed, and you have been asked to present your plan—including operational recommendations and strategic control mechanisms—at a strategic visioning session with key stakeholders (senior leaders if your plan is organization-wide, community leaders if your plan is for a community health project, or the nurse manager of a specific department or team). This session is the next step in moving your plan toward implementation. Your deliverable for this assessment is a slide deck of 10–20 slides to supplement your presentation and facilitate discussion of your plan. You may use Microsoft PowerPoint or any other suitable presentation software. Please use the notes section of each slide to develop your talking points and reference your sources, as appropriate. If you choose to use PowerPoint and need help designing your presentation, a link to Microsoft tutorials is provided in the Supplemental Resources in the left-hand navigation pane of your FlexPath courseroom. An additional PowerPoint guide is linked in the Resources. Presentation Design Tips Being able to effectively address any audience is a necessary leadership skill. Remember that you are the speaker, not a projectionist. Your purpose is not to present a slide show. Your audience is there to listen to what you have to say, not read your slides—or worse, listen to you read them. Design your presentation slides to compliment and reinforce your message and engage your listeners. The following tips will help you create presentation slides that work to your advantage: Focus on the content of your presentation and the development of your main points. Remember that your purpose is to garner support for your plan and build partnerships for implementation. Consider your intended audience and how best to communicate effectively with them. Create slides that support your presentation. They should not be your presentation. Use a professional presentation template, or one used in your organization. Ensure that your slide background provides sufficient visual contrast for your text and graphics. Avoid filling your slides with text. Use speaker notes to record the details you want to communicate to your audience. Be judicious in your use of bulleted lists. You might even consider a separate slide for each main point. Use images and graphics, when appropriate, to illustrate information and make your points. Presentation slides are a visual medium. Images are more effective than text at engaging your audience. Avoid using images that are simply decorative. They can be a visual distraction and do not contribute to your message. Avoid using flashy slide transitions and animations. They can be both distracting and annoying. Keep your slide transitions consistent throughout the presentation. Add a slide to the end of your presentation to prompt questions from the audience. Requirements Note: The requirements outlined below correspond to the grading criteria in the scoring guide, so, at a minimum be sure to address each point. In addition, you are encouraged to review the performance level descriptions for each criterion to see how your work will be assessed. Communication, Supporting Evidence, and APA Style Present your plan in a professional and respectful way, with the goal of garnering support for your plan and building partnerships for implementation. Address stakeholders' needs and concerns. Communicate the need to work collaboratively on implementation. Integrate relevant and credible sources of evidence to support your assertions. Cite at least 3–5 sources of scholarly or professional evidence. Apply correct APA formatting to all in-text citations and references. Add a references slide to your slide deck. Proofread your slides to minimize errors that could distract the audience and make it more difficult to focus on the substance of your presentation. Presentation Summarize your plan for achieving 2–3 main goals. Include corresponding metrics, targets, and initiatives to help achieve the desired quality or safety improvements in the care setting. Note: It may be useful to think about what you hoped to achieve in addressing your care setting's positive core or specific area of concern in Assessment 1. For example: Progress toward achieving the Triple Aim. Better patient safety outcomes. Lower readmission rates. Higher volume of patients and care. Increased financial gain. Minimizing staff burnout. Improved relationship and trust with the community or a specific population. In addition, remember to consult the literature, research studies, and resources from professional and governmental organizations when developing metrics, targets, and initiatives. Explain how you will communicate your plan to those stakeholders and constituencies who are essential to implementing your plan and sustaining strategic direction. Identify the key individuals or groups with whom you must communicate. Identify the cultural or ethical factors, if any, that are relevant to the design of your communication plan, including how key individuals or groups typically prefer to be contacted. Describe the actions you will take to align your care setting's structure, systems, shared values, management style, staff, and skills with your strategic goals. Describe the changes that are needed to achieve your goals. Describe the goals and processes for on-boarding relevant individuals or groups. Explain how you will evaluate the success of your strategic plan. Define successful implementation. Describe the successful outcomes for this project. Explain how will you compare outcomes to current performance benchmarks. Explain how will you collect data to evaluate whether you have achieved specific goals and outcomes. Identify your priorities, assuming you cannot accomplish everything. Explain how relevant cultural, ethical, and regulatory considerations influenced the design of your strategic plan and strategies for its implementation. Explain your role, as a nurse leader, in successfully implementing your proposed plan and sustaining strategic direction. Explain how leadership and health care theories support your role. Explain why your leadership qualities and skills will enable you to successfully implement your plan and sustain strategic direction. Explain why should you be the one to lead this initiative. Explain how have you demonstrated some or all of these qualities in past work. Additional Requirements In addition to your slide deck, submit any other relevant documentation or links for this assessment (if you used presentation software or technology other than PowerPoint). Portfolio Prompt: You may choose to save this learning activity to your ePortfolio. Strategic Visioning With Stakeholders Scoring Guide Use the scoring guide to enhance your learning. VIEW SCORING GUIDE How to use the scoring guide SUBMIT ASSESSMENT This button will take you to the next available assessment attempt tab, where you will be able to submit your assessment. Strategic Visioning With Stakeholders Scoring Guide CRITERIA NONPERFORMANCE BASIC PROFICIENT DISTINGUISHED Summarize a strategic plan aimed at achieving desired quality or safety improvements within a care setting. Does not summarize a strategic plan aimed at achieving desired quality or safety improvements within a care setting. Summarizes a strategic plan aimed at achieving desired quality or safety improvements within a care setting, but the plan lacks corresponding metrics, targets, or initiatives, or is impractical or poorly suited to the desired improvement. Summarizes a strategic plan aimed at achieving desired quality or safety improvements within a care setting. Summarizes a strategic plan aimed at achieving desired quality or safety improvements within a care setting, and notes inherent weaknesses or threats. Explain a strategy for communicating with stakeholders and constituencies who are essential to implementing a strategic plan and sustaining strategic direction. Does not explain a strategy for communicating with stakeholders and constituencies who are essential to implementing a strategic plan and sustaining strategic direction. Explains a strategy for communicating with stakeholders and constituencies that is impractical, unrealistic, or inappropriate for the intended audiences. Explains a strategy for communicating with stakeholders and constituencies who are essential to implementing a strategic plan and sustaining strategic direction. Explains a strategy for communicating with stakeholders and constituencies who are essential to implementing a strategic plan and sustaining strategic direction, and identifies assumptions on which the strategies are based. Describe the necessary actions for aligning the structure, systems, shared values, management style, staff, and skills of a care setting with strategic goals. Does not describe actions for achieving strategic goals. Describes actions for achieving strategic goals that are impractical, or does not sufficiently address the structure, systems, shared values, management style, staff, and skills of the care setting. Describes the necessary actions for aligning the structure, systems, shared values, management style, staff, and skills of a care setting with strategic goals. Describes the necessary actions for aligning the structure, systems, shared values, management style, staff, and skills of a care setting with strategic goals; proposes criteria for evaluating the success of orientation and onboarding. Explain how the implementation and outcomes of a strategic plan will be evaluated against current performance benchmarks. Does not explain how the implementation and outcomes of a strategic plan will be evaluated against current performance benchmarks. Explains how the implementation and outcomes of a strategic plan will be evaluated, but descriptions of successful implementation and outcomes lack clarity or reference to existing benchmarks, data collection plans, or prioritization. Explains how the implementation and outcomes of a strategic plan will be evaluated against current performance benchmarks. Explains how the implementation and outcomes of a strategic plan will be evaluated against current performance benchmarks, and identifies areas of uncertainty or knowledge gaps. Explain how relevant cultural, ethical, and regulatory considerations influence the design of a strategic plan and strategies for its Does not explain how relevant cultural, ethical, and regulatory considerations influence the design of a Explains how cultural, ethical, and regulatory considerations influence the design of a strategic plan and strategies for its implementation, but some considerations are missing, Explains how relevant cultural, ethical, and regulatory considerations influence the design of a Explains how relevant cultural, ethical, and regulatory considerations influence the design of a strategic plan and strategies for its implementation; identifies implementation. strategic plan and strategies for its implementation. or it is not clear that they have been applied to decision making. strategic plan and strategies for its implementation. potential conflicts related to cultural, ethical, and regulatory considerations. Explain one’s role, as a nurse leader, in successfully implementing a strategic plan and sustaining strategic direction. Does not explain one’s role, as a nurse leader, in successfully implementing a strategic plan and sustaining strategic direction. Explains one’s role, as a nurse leader, in successfully implementing a strategic plan and sustaining strategic direction, but fails to cite supporting leadership or health care theories. Explains one’s role, as a nurse leader, in successfully implementing a strategic plan and sustaining strategic direction. Explains one’s role, as a nurse leader, in successfully implementing a strategic plan and sustaining strategic direction, and identifies assumptions. Explain why one’s leadership qualities and skills are well suited to successfully implementing a strategic plan and sustaining strategic direction. Does not explain why one’s leadership qualities and skills are well suited to successfully implementing a strategic plan and sustaining strategic direction. Explains why one’s leadership qualities and skills are well suited to successfully implementing a strategic plan and sustaining strategic direction, but fails to make a convincing case for leading the initiative. Explains why one’s leadership qualities and skills are well suited to successfully implementing a strategic plan and sustaining strategic direction. Explains why one’s leadership qualities and skills are well suited to successfully implementing a strategic plan and sustaining strategic direction, including plans that acknowledge opportunities for personal growth. Communicate analyses clearly and in a way that demonstrates professionalism and respect for stakeholders and colleagues. Does not communicate analyses clearly and in a way that demonstrates professionalism and respect for stakeholders and colleagues. Communication is not consistently clear and professional; errors in grammar or mechanics distract from the message, or communication lacks respect for stakeholders or colleagues. Communicates analyses clearly and in a way that demonstrates professionalism and respect for stakeholders and colleagues. Communicates analyses clearly, logically, and persuasively, demonstrating professionalism and respect for stakeholders and colleagues. Grammar and mechanics are virtually error-free. Integrate relevant and credible sources of evidence to support assertions, correctly formatting citations and references using APA style. Does not integrate relevant and credible sources of evidence to support assertions; does not correctly format citations and references using APA style. Sources lack relevance or credibility, are poorly integrated, or are incorrectly formatted. Integrates relevant and credible sources of evidence to support assertions, correctly formatting citations and references using APA style. Integrates relevant and credible sources of evidence to support assertions, correctly formatting citations and references using APA style. Citations are errorfree. Running Head: CARE SETTING ENVIRONMENTAL ANALYSIS Care Setting Environmental Analysis Dezene Thompson Capella University Leadership Management Nurse Executives Care Setting Environmental Analysis August, 2018 1 CARE SETTING ENVIRONMENTAL ANALYSIS 2 Part 1: Appreciative Inquiry Discovery and Dream Appreciative Inquiry (AI) represents one of the most important change approaches that promise to energize quality management in healthcare. According to MacCoy (2014) whatever the situation one encounters, the first step is always to discover and disclose the situation’s positive capacity. The aim of this stage is to find, emphasize and highlight all factors that have led to success in similar situations. The best approach to discover the best method is to first look at the peak experiences. However, one should also look at what touches his/her heart and spirit and motivates him/her to look at reality differently. On the other hand, dream entails the act of focusing on the possibility of what could be rather than the limiting factors of what is. One is focused on seeing and understanding things in a new way. In healthcare organizations, quality management often seems more like a burden than an opportunity for growth. Such is the situation at Rieging Medical Center (RMC). Synthesize Stories Stories were collected from care setting through conversation with colleague mixed with the writers own experience. RMC has a safety culture. Stories by staffs act as evidence to this culture. The stories contain the five attributes of a safety culture. The stories collected relate to improved outcome of patients with cardiac arrested and sepsis in the Emergency Room. a. RN I, states that the codes are usually very organized and all the staff know their roles. Staff are very knowledgeable of their job. All available staff responds initially, take a role and any extra staff would circulate as not to crowd the room. b. RN II, states that resources are usually readily available and stocked appropriately. The ED Techs are very responsive and starts CPR as soon as the patient crashes. A second tech is CARE SETTING ENVIRONMENTAL ANALYSIS 3 always on stand by for two minute switches as to not exhaust one person and also to ensure high quality CPR is maintained throughout the arrest. c. RN III, states that as soon as Return of Spontaneous Circulation (ROSC) is achieve cooling therapy protocol is initialed to cool the body and decrease brain activity. Family members are always kept updated and abreast of what’s going on with the patient. Another story collected from staff was about initiating sepsis protocol and work up after a code sepsis has been called. When a patient meets two or more of the criteria on the sepsis screening tool, for example low blood pressure, hyperthermia or hypothermia, elevated white blood cell count or an elevated heart rate would trigger a Systemic Inflammatory response syndrome (SIRS) alert. If the patient meets this criteria and has any evidence of suspicious infection then a code sepsis will be called overhead. Staff states that when a code sepsis alert is called the physician, at least one RN and a Tech response to assist the primary nurse. First, blood cultures are drawn, along with additional blood work if needed, like a lactate level, if it wasn’t already obtained. Antibiotics are given within an hour intravenously, starting with a broad spectrum, mostly Zosyn and then Vancomycin, pending blood culture results. Intravenous fluid resuscitation is started at 30mls/kg. Two large bore IV access are placed, if the patient doesn’t already have them. Vital signs are monitored per acuity but mostly every 30 minutes. If the patient is hypotensive then a vasopressor like Levophed is started in an effort to achieve an optimal blood pressure to support brain function. The patient is monitored closely and admitted to the ICU. Stories Relate to Quality and Safety CARE SETTING ENVIRONMENTAL ANALYSIS 4 First, the ones who manage and operate the system at RMC have current knowledge about all the aspects that determine the safety. Secondly, it is a healthcare facility where people report errors and near-misses. Thirdly, an atmosphere of trust is encouraged and even rewarded. Fourthly, staffs effectively adapt to changing demands. Finally, staffs are willing and competent to make the right conclusions, be corrected and complete continuing education courses. Previously, RMC tried to improve patient outcomes after having suffered crises such as cardiac arrest and sepsis after which it enhanced its existing emergency response capability. RMC started intervening earlier with patient showing signs of medical deterioration. These were often the case before these crises. RMC started a rapid response team (RRT) consisting of three team members, including a physician assistant (team leader), a respiratory therapist, and a critical care nurse. Currently, the team takes actions that are needed to stabilize the patient’s condition, including reporting and consulting with the ICU physician intensivist. The transfer of patients to the ICU is carried out in time. Every staff in the hospital was trained on the purpose and use of the rapid response team before the team was developed. Two months after implementation, calls for the rapid response team started increasing indicating that awareness of the importance of the rapid response team among staffs was increasing. After 2 more months a 60 percent decrease in emergency calls for respiratory arrest were recorded. In addition, a 15 percent decrease in cardiac arrests was recorded (Ruhe et al., 2011). Evidence to Substantiate Stories According to Robson & Daniels (2013), in hospitals, early warning scoring systems (EWS) are routinely used in order to identify patients with physiological deterioration. Any patient with an infection and any patient who has a raised EWS should be screened for the suspicion of sepsis. CARE SETTING ENVIRONMENTAL ANALYSIS 5 As an operational solution to this complex bundle, the UK Sepsis Group developed the concept of the ‘sepsis six’—a set of six tasks, including oxygen, cultures, antibiotics, fluids, lactate measurement and urine output monitoring, to be instituted within 1 hour of the patient showing signs of suspicious sepsis. Compliance with the sepsis six has been shown to reduce the relative risk of death by 46.6%. Other evidence that validates RMC care setting positive core are: a. The Magnet Designation recognition status that they have achieved and maintained three times in a role. Magnet recognition from the American Nurses Credentialing Center (AACC) is the highest and the most prestigious distinction a healthcare organization can receive for nursing excellence and high-quality patient care. Only 8% of U.S. hospitals earn the magnet designation. b. The Lantern Award that they received. The Emergency Nurses Association Lantern Award recognizes emergency departments that demonstrates exceptional and innovative performance in leadership, practice, education, advocacy and research. c. A few nurses have also received the Daisy Award. The Daisy Award is awarded by the Daisy Foundation. It is an inspirational morale booster and a strategic tool for nurse recruitment and retention. It was created in memory of Patrick Barnes, who received excellent nursing care before his death at 33 years old from Idiopathic Thrombocytopenic Purpura (ITP). Quality and Safety Improvement Goal The goals for RMC are: CARE SETTING ENVIRONMENTAL ANALYSIS 6 a. To improve early detection of sepsis in the emergency room (ED). Not all septic patients are caught early enough or even in the ED. ➢ Early detection of sepsis can be achieved by using monocyte distribution width (MDW) best discriminated sepsis from all other conditions. The added value of MDW to WBC count was statistically significant. Crouser et al (2017) states, the incorporation of MDW with WBC count is shown in this prospective cohort study to improve detection of sepsis compared with WBC count alone. b. Improve awareness of all staff of the importance and significance of caring for a septic patient in a timely manner. ➢ This will be accomplished by using evidence based practice to care for all patients. Staff should be knowledgeable, competent and be current with hospital competency and procedures. This will be ensure by completion of mandatory annual competencies. A strong and effective leader and his employees use Evidence Based Practice (EBP) when caring for patients. They are also required have the necessary knowledge, skills and attitude to provide competent care to clients/patients for a range of diverse cultures. During decision making leadership should not only consider EBP but also upholding employee’s dignity but also being fair, ethical and professional. Practicing from a culturally sensitive ethical perspective in a multicultural context is essential for good practice. Health care professionals need to be able to communicate effectively and to understand each client’s/patient’s unique background and beliefs, and make decisions that will meet each client’s/patient’s needs in a thoughtful, sensitive and effective manner. A common ethical dilemma arises when respect for autonomy and cultural sensitivity collide. Health care CARE SETTING ENVIRONMENTAL ANALYSIS 7 professionals may use a number of resources to address ethical dilemmas in multicultural contexts, such as the frameworks for ethical decision making. Ethical decision making frameworks typically begin with developing ethical sensitivity, which is the ability to recognize that an ethical issue exists. The key characteristics of ethical sensitivity as moral perception (identify client and situational needs), affectivity (putting self in place of clients to identify and weigh comparable reactions) and dividing loyalties (awareness of moral and ethical principles, their significance in the context, stakeholders’ needs and interests). These attributes enable health care professionals to recognize, understand and evaluate ethical elements in clinical practice. The more skilled a health care professional is in terms of ethical sensitivity, the easier it is to use a framework for ethical decision making. The proposed goals align with RMC mission, vision and value because it will uphold the mission to provide quality care to all patients and to achieve optimum outcome for all patients treated, the vision of making RMC the healthcare of choice based on its reputation and success stories and its value to treat all patients as equal, fairly and with respect and deliver care in an ethical and professional manner. Part 2: SWOT Analysis RMC’s SWOT Analysis RMC is a healthcare establishment in which many people in Area B have faith in. The clinic has all departments, including an emergency department. People in the area visit the hospital for services, including handling of emergencies such as accidents, and other small health issues. CARE SETTING ENVIRONMENTAL ANALYSIS 8 RMC was established in 1991 and has experienced growth since then. The hospital has some of the most experienced doctors in the area. Strengths Strengths of any organization account for the positive aspects of any brand. RMC’s strengths make it one of the most favorable hospitals in the area. a. Highly qualified and experienced doctors and staff: Doctors and staffs in the hospital are what make the facility the preferred choice for the people in the area. The hospital has a very complex hiring process which ensures that it hires the most qualified doctors and other hospital staff. Most of the nurses are BSN trained and board certified as RMC is a magnet hospital. These strength are the most important factors that distinguish RMC from other hospitals, not only in this area but the entire region. b. Brand name: RMC has over the years established itself as the most desirable hospital in the area. It has become popular, not only among the local people but the whole region. People travel for hundreds of kilometers to seek medical services at RMC. This brand name has been built through many years of hard work and dedication. RMC is so popular because of the superior care that patients received and the high customer retention, the most modern equipment available, well trained staff in every specialty, c. High quality medical services: This is one of the positive aspects of RMC Clinic. The two departments that have contributed to this popularity are the emergency department and outpatient section. RMC is a level II trauma center and most of the emergences in the region are referred to RMC, including accidents. There are other departments that have CARE SETTING ENVIRONMENTAL ANALYSIS 9 contributed to this popularity, including the cancer center, pediatric, and dialysis departments. Weaknesses Weaknesses are the factors that reduce a company’s ability to achieve its objectives and account for the downside in a brand’s services. Although RMC does not have many weaknesses, it has some significant ones that can affect its performance. Some of RMC’s weaknesses are: a. High service cost: Since the clinic has been operational for many years, it is supposed to have addressed the problem of high costs. Even though it provides high quality services, it is important that it provides affordable services. Some of the services such as cancer treatment are provided at costs that are unreachable by many people in the area. The clinic is located in an area where most people are medium income earners. b. Limited number of staff: Depending on the number of people that visit the hospital in a day. The ratio of doctor to patients is 1:50. Due to the fact that there are some patients whose conditions require considerable amount of time, the number of doctors in the hospital cannot adequately cater for all patients. There is also an issue with staff retention. It was identified that there is a high staff turnover especially for the nurses. c. Unreliable suppliers: RMC sometimes are short on supplies because the supplier doesn’t deliver the good on time and so patient test, care and results end up delayed which in turn lengthen the patient hospital stay. Opportunities Many hospitals in the region do not offer some of the services that are offered at RMC representing the reason why many people travel for long distances to seek services at RMC clinic. CARE SETTING ENVIRONMENTAL ANALYSIS 10 Some of these services include cancer treatment and gynecological services. Based on this fact, RMC has an opportunity to open branches in other areas to take its services closer to the people that require them. Therefore, RMC has an opportunity for expansion of its operations and market new products easily since the name is already well known. Threats Threats represent the obstacles that stand on the path of success. The only significant threat for RMC is the new emerging hospitals which are likely to pose threat to RMC in the years to come. Hospitals in the region are increasingly investing in new medical technologies and inventions. In addition, they are increasingly evolving in terms of service provision. This represents one of the most significant threats that RMC is likely to encounter in the near future. Key Findings and Relationship to Quality and Safety Goals The keys findings in this SWOT analysis and their relationship to quality and safety goals are short staff, high staff turnover, high service cost and unreliable suppliers. With RMC’s being short staff and having a high staff turnover this will affect quality of patient care and patient outcome. Short staff leads to increase length of stay, increase morbidity as problems are not addressed in a timely manner, increase medical and medication errors, increase mortality and poor patient satisfaction. High staff turnover can lead to safety concerns since management will constantly have to train new nurses and might be forced to pull these new nurses off orientation early to meet the needs of the department. With the high service cost that patients have to pay this will put a strain on the patients finances and caregiver and might force them to stay at home longer before seeking medical assistance while symptoms are worsening. These issues both affect quality of care and patient safety. CARE SETTING ENVIRONMENTAL ANALYSIS 11 An Area of Concern Identified In the SWOT that Needs Improvement One area of concern that was identified in the SWOT analysis – relevant to RMC care setting’s mission, vision and values for which there will be proposed improvement is that there is a high staff turnover rate especially for the nurses. RMC’s mission is to provide quality care to all patients and to achieve optimum outcome for all patients treated. With a high staff turnover rate the quality of care is likely to be affected, decreasing patient outcome and satisfaction. The vision is making RMC the healthcare of choice based on its reputation and success stories. RMC reputation will be damage and possibly lead to decreasing patient influx. Its value is to treat all patients as equal, fairly and with respect, delivering care in an ethical and professional manner. It might be difficulty for staff to deliver care in an ethical manner doing no harm and with respect with short staffing and nurse burn out. It is necessary and valuable to pursue improvement for the high staff turnover if RMC wants to keep providing quality and safe care to the community that it serve and the patients who they treat and if they are going to maintain and uphold their mission, vision and value. Criteria’s that can be used to improve high staff turnover are: ➢ Employ more nurses, temporary staff (travelers) and support staff like techs for nurses so they don’t feel burned out or overwhelmed. ➢ Use incentives and praise to keep staff motivated and encourage them to keep doing well. Recognized staff for good deeds and good work. ➢ Create a retention and recruitment committee dedicated to dealing with staffing issues and ways to recruit, retain and hire new staff. ➢ Offer sign-on bonus with a least a 2 year contract for new staff. CARE SETTING ENVIRONMENTAL ANALYSIS 12 Part 3: Comparison of Approaches The organizational outcomes in making use of AI are completely different compared to when a person is using SWOT analysis. First, SWOT analysis has a very low level of engagement compared to AI. AI collects information by asking questions regarding the strengths and weaknesses of the organization or the issue at hand. AI takes into account each set of questions contrary to SWOT analysis. Therefore, AI focused more on specific areas. In addition, it collects different perspectives from different members of the team. Thirdly, SWOT usually makes generalization contrary to AI which focuses on specific areas. In addition, AI stimulates and encourages positive outcomes. The AI approach will enable RMC to consider the manner in which it perceives itself as the best healthcare institution in Area B in the delivery of healthcare services. The approach avoids focusing on negative aspects. Instead, it determines how it can restructure its operations so as to address its challenges. Part 4: Analysis of Relevant Leadership Characteristics and Skills Leadership is very important especially in healthcare. Leadership is not traditionally taught in medical schools. However, hospital leaders are required to possess high quality leadership skills to lead their healthcare organizations to success. RMC Health Clinic recognizes the importance of engaging its staff in leadership roles. One of the nurses at RMC indicated that every staff in the clinic has the ability to lead a team in his/her respective area because the management of the hospital ensures it provides them with opportunities to develop their leadership skills. Team leaders were found to have high quality leadership skills. One of the areas they were found to be highly skilled in communication skills. These skills create great understanding between the leaders and their subordinates and between the management and employees. RMC staffs are CARE SETTING ENVIRONMENTAL ANALYSIS 13 also trained in team building skills. The group meetings that were conducted to obtain information for the present paper revealed that no staff member dominates others during conversation, implying that each staff member has excellent team-building skills. CARE SETTING ENVIRONMENTAL ANALYSIS 14 References Crouser, E., Parrillo, J.E., Seymour, C., Angus, D.C., Bicking K., Tejidor, L., Magari, R., Careaga, D., Williams. J., Closser, D.R., Samoszuk, M., Herren. L., Robart. E., Chaves. F. (2017). Improved early detection of sepsis in the ED with a novel monocyte distribution width biomarker. Chest. September 152 (3), 518-526. doi: 10.1016/j.chest.2017.05.039. Cooperrider, D., & Whitney, D. (2001). A Positive Revolution in Change: Appreciative Inquiry. Public Administration and Public Policy, 87, 611-630 Deisher, M. (2013). A systems change: Leading the way to meeting health needs. Journal of Hand Therapy, 26(3), 282-285, 286. Grossman, S.C., & Valiga, T.M. (2012). The new leadership challenge: Creating the future of nursing. Philadelphia, PA: F.A. Davis Company.MacCoy, D. J. (2014). Appreciative inquiry and evaluation – Getting to what works. The Canadian Journal of Program Evaluation, 29(2), 104–127. Robson, W., & Daniels, R. (2013).Diagnosis and management of sepsis in adults. Nurse Prescribing, 11 (2), 76-82. Ruhe, M. C., Bobiak, S. N., Litaker, D., Carter, C. A., Wu, L., Schroeder, C., & Stange, K. C. (2011). Appreciative inquiry for quality improvement in primary care practices. Quality management in health care, 20(1), 37. Running head: STRATEGIC PLANNING Strategic Planning of a Behavioral Health Facility Dezene Thompson Capella University Leadership and Management for Nurse Executive Strategic Planning August, 2018 1 STRATEGIC PLANNING 2 Directional Strategic Planning of a Behavioral Health Facility The organizations’ executive managements or board of directors never take lightly the direction in which the organization needs to take as it continues with its operations. The purpose of any healthcare organization in having mission and vision statements is to have something that that will help them inform the community about what they offer and how they will fulfill their pledge to the community. It is very important that every healthcare organization has its own vision and mission statement – one that is distinct from those of other organizations. Healthcare facilities usually utilize their mission statements to explain the meaningful strategies and goals they wish to fulfill. According to Curran (2015), a mission statement is focused on energizing and exciting stakeholders and highlighting the uniqueness of the facility. It is important for any healthcare facility to have a mission statement so as to inform its clients what differentiates the facility from other care facilities. Healthcare facilities usually make broad and inspiring vision and mission statements which mainly describe what the organization wants to achieve towards its successful future. However, it does not include specific details in the vision statement. According to Curran (2015), the role of the vision statement is to give a description of what the organization will do to meet its stakeholders’ expectations and needs. In addition, organization’s values have to be consistent with the vision and mission statement. These values are the factors that drive what the organization does to support its vision and mission statement. Within these value statements, the identity of the organization becomes clear (Curran, 2015). It is the role of the organization’s board of directors to develop and maintain these three important factors. The role of developing, agreeing upon, and disseminating the information carried by the three statements is within the mandate of the board of directors. It is important for every staff within the organization to STRATEGIC PLANNING 3 understand these statements. Understanding the three statements helps staffs to cooperate with the board of directors towards forming the strategic plan of the organization. According to the Schroeder (2014), a strategic plan is the systematic process, method, or plan through which the organization envisions the future it desires, translates this vision into goals (which are usually widely defined), and describes all the steps it needs to take towards achieving this plan. It is important for the organization to continuously keep on reviewing its mission, vision, and value statements. The main reason behind reviewing these statements is that some of them may become obsolete or irrelevant in the course of business process. The interaction between these aspects is very important because it determines the final outcomes of the organization’s operations. This paper is focused on investigating the interaction between these aspects. Mission, Vision, and Value Statements Philhaven is one of the behavioral health facilities located in Lancaster County in Pennsylvania. The facility has a capacity of 103 beds. It has a wide range of services it offers to its clients, including outpatient services, inpatient services, extended acute care, relationship counseling, day hospital services, employee assistance programs, and group therapy among other healthcare services. The facility has different outlets. For example, the section offering inpatient facility is located in Mr. Gretna, PA. There are other offices located around Lancaster County. Based on Philhaven, its mission is to promote hope, healing, and wholeness as it provides its clients with compassionate care. Its patients include individual clients and families. Although its website does not state that this is Philhaven’s statement, it touches all areas that may be considered important when providing healthcare services to people with behavioral health issues. “As an expression of Christ’s love, Philhaven promotes hope, healing, and wholeness through the provision of behavioral healthcare resources” represents Philhaven’s mission statement STRATEGIC PLANNING 4 (Philhaven, 2016). “Finding a better way to nurture mental health and resilience” represents Philhaven’s vision statement (Philhaven, 2016). Despite the fact that the mission and vision statements of this facility are clear, they seem to be missing certain important factors. For example, the mission statement mentions something about utilizing behavioral healthcare resources but does not state what these resources are. It is important for the mission statement to include a description of how it intends to work with the clients because in such a way, it gives more credence to the statement. For example, in Mental Health America (2016), the mission statement states that it will utilize advocacy, education, research, and service to address the problem of mental health illnesses. Compared to Philhaven, the vision statement for Mental Health America seems more developed and up-to-date. Although Philhaven’s vision statement is broad, it seems to have been written many decades ago. The organization does not seem to update its vision statement with time. Mental Health America has discussed its desire for the future of its clients – a future in which its services will be more humane, in which clients will be treated with greater dignity, and one in which they will be free from discrimination. In terms of value statement, Philhaven’s value statement seems appropriate for a behavioral health facility. It describes its values as compassion, wholeness, respect, accountability, excellence, and ethics. These expectations are very reasonable for both the staffs and patients. However, its vision and mission statements do not seem consistent with a desired strategic plan for a behavioral health facility. In comparison, Mental Health America’s vision and mission statement have been found to be more consistent with a desired strategic plan. Therefore, a combination of Mental Health America’s vision and mission statements and STRATEGIC PLANNING 5 Philhaven’s value statement would produce a very strong strategic plan – one that would be appropriate for a behavioral health facility. Quality and Safety Behavioral health facilities have to take care of all the issues related to quality and safety. It is important for any behavioral health facility to have a strong sense of safety in all its facilities due to the nature of patients’ conditions and uncertainty. Giving high quality healthcare represents the way in which this can be assured. Philhaven have not mentioned anything to do with quality or safety in its vision and mission statements. Mental Health America does not mention them too in its mission and vision statements. The main objective of developing a strategic plan based on facility’s mission and vision statements is to reduce stressors for every behavioral health patient. It is important for such healthcare organizations to establish their facilities in areas that will promote calmness so as not to escalate patients’ problems. The environment on which such a facility is established represents the first step to ensuring that these patients are safe. In addition, it is important for these facilities to ensure they minimize vulnerability and risk by conducting regular assessments to identify and eliminate any internal and external vulnerability. According to Briefings on Hospitals Safety (2016), it is important to conduct joint education involving clinical and support staffs to address issues such as ones involving patients that require additional safety precautions such as visitor control. Quality is ensured in a behavioral health facility when the facility ensures that clients are safe as one of its quality measures. Quality care is offered in safe environments. Cultural and Ethical Environments Culture is defined as the beliefs and behaviors that characterize a particular ethnic, social, or age group (Dictionary.com). It is important for any behavioral health facility to take into STRATEGIC PLANNING 6 consideration client’s culture when providing services. Philhaven does not mention culture in its mission statement. Cultural consideration is very important when any healthcare organization is dealing with its patients. Another aspect considered important for behavioral health facilities regards ethical considerations because ethical issues are closely intertwined with other challenges that are common in behavioral healthcare. According to Hem, Pedersen, Norvoll & Molewijk (2015), it is possible to improve the future of behavioral health care if facilities offering these services evaluate the nature of ethical support services available. According to Hem et al. (2015), it is important for the behavioral healthcare facilities to share information regarding their services and ethical support provided to their clients. This information may be scientific or based on evaluation. Philhaven shares some behavioral healthcare resources in its mission statement. These facilities should ensure that there is a section within their mission statement that provides on how they collect and share information related to disease treatment so that the patients can be able to determine whether the care that will be provided in such facilities matches their needs. Technology Philhaven did not mention anything to do with the utilization of technology in its facilities in both its vision and mission statements. It would be appropriate for the facility to provide information on its use of Electronic Health Records (EHR) in its mission statement. Although EHRs did not find their way into the healthcare system a long time ago, it has become appropriate for them to be used in the behavioral healthcare facilities. There is minimal use of EHR in behavioral healthcare facilities. These records will require these facilities to train their staffs on how they can use these records. According to Strudwick & Eyasu (2015), behavioral healthcare organizations that have already implemented these records within their systems have STRATEGIC PLANNING 7 the ability to communicate with the larger behavioral healthcare community with success. There are several functions contained in most EHRs that help staffs to care for their clients. According to Strudwick & Eyasu (2015), the main role of EHRs is to document nurses’ clinical assessment, testing and imaging results, computerized order entry by doctors, and decision support. EHRs are new in behavioral healthcare facilities. Most behavioral healthcare facilities’ strategic plans do not align with EHRs. Therefore, it is important for these facilities to update their mission, vision, and value statements so as to take into consideration electronic recording. Integrating Leadership and Health Care Theories Leadership and health care theories will be integrated in an attempt to achieve the strategic goals and objectives of Philhaven. This is achievable if leadership capitalizes on the diversity within the organization as a whole and efficiently utilizes resources when designing management processes, while encouraging personnel to work towards common goals (Al-Sawai, 2013). A few leadership theories have been adapted and will be used to show how to achieve strategic goals as shown below: The transformational theory is perfect for this setting as it focuses on supervision, organization and group performance, and emphasizes that people work more effectively if they have a sense of mission. According to Al-Sawai (2013), the transformational theory requires leaders to communicate their vision in a manner that is meaningful, exciting, and creates unity and collective purpose; the manager who is committed, has vision, and is able to empower others can be described as a transformational leader. Transformational leaders are able to motivate performance beyond expectations through their ability to influence attitudes. Another leadership theory that has been adapted is shared leadership theory. Leadership needs to focus on the development of effective collaborative relationships through support and STRATEGIC PLANNING 8 task delegation, and this could be the basis for widespread implementation of the shared leadership model within the healthcare setting, as it encourages shared governance, continuous workplace learning and development of effective working relationships (Al-Sawai, 2013). Employee’s may be more enthused to carry out the mission and vision statement of Philhaven if they are made to feel like they are a part of a team with shared responsibilities versus someone barking orders at them. This will also decrease resistance to change. Leadership have to be mindful that there are some limitations to the transformational leadership theory so as not to repeat them, these may include unclear governance structure, unclear scope of practice, poor communication and abuse of transformational power. According to Al-Sawai (2013), shared leadership is a system of team-level management/leadership that empowers staff within the decision-making processes. It offers the opportunity for individuals to both manage and develop within a team and is effective at improving the work environment and job satisfaction. Effective teamwork is key to the sharedleadership approach, with a focus on identifying team values and optimizing team efficiency to improve practices. Shared leadership ideally results in individual staff members adopting leadership behaviors, greater autonomy, and improved patient care outcomes. Barriers to developing shared leadership can include a poor team ethos, high workload and staff turnover rates, uninteresting work, lack of responsibility, and insufficient goal setting. Leadership Skills and Attributes A good leader must have intentions, values, and behaviors that intend no harm and respect the rights of all parties. In addition to cultivating a conducive environment that is built on a strong foundation, effective leaders must exhibit specific skills and attributes to achieve the goals of the organization. These skills include but are not limited to excellent communication STRATEGIC PLANNING 9 skills, empathy and emotional intelligence, team-building skills, an understanding of the competitive landscape, strategic thinking, and courage. • Communication Skills. Rihal (2017) reiterates, the most important tool that leaders possess is communication. Effective communication ensures understanding. Communication is a two-way interaction, and the ability for the leader to listen is critical. Leaders should practice active listening, rather than just being quiet while others speak. A simple but effective way to practice active listening is to take mental notes while others are speaking or communicating. Being heard is important to others, even if final decisions are not what were initially requested. • Empathy and Emotional Intelligence. Empathy and emotional intelligence are key leadership traits that frequently are overlooked. Leaders regularly are called upon to deal with challenging and, at times, unpleasant situations (e.g., conflict situations, crucial conversations, and some annual performance reviews). Having a high degree of emotional intelligence will enable the leader to deal with such situations effectively and objectively while not avoiding the underlying issues. It is important to note that emotional intelligence is a skill like any other and can be developed with practice and coaching. Similarly, an empathic leader who can sense how others feel will be a much more effective communicator and team builder and will be more likely to effectively manage change. Interestingly, this same trait is critical to developing the patientphysician relationship (Rihal, 2017). • Team-Building Skills. The most effective teams include talented individuals with complementary areas of expertise who are comfortable expressing their opinions. It is the responsibility of the leader not to dominate the conversation and to ensure that teams feel STRATEGIC PLANNING 10 safe speaking up. The effective leader trusts the team members, challenges them, and lets them handle difficult situations. When difficult decisions are required, leaders and their teams will require a high degree of emotional intelligence and courage to make the right decisions for the organization, even if doing so presents challenges in the short term. Courage in leadership is yet another skill that can be developed with practice over time. What is required is a commitment to fairness, transparency, and doing the right thing (Rihal, 2017). Policies, Laws, and Regulations Organizations develop policies, regulations, and procedures based on their organizational cultures. For behavioral healthcare facilities, they should develop policies that are aligned with the care for their clients and based on the severity of the issues expected to be reported. Policies and procedures help guide future decisions and actions. According to Randolph (2006), decision making processes, actions to be taken, and practices and procedures to be carried out by any organization are defined by the policies developed by that particular organization. One of the procedures that behavioral healthcare organizations should implement regards responses to issues such as elopement, seclusion room management, combative behavior, and restraint use among other security issues. Another issue that must be taken into consideration regards processes conducted during treatment or admission of the clients, including client history assessment, securement of clients’ belongings, visitor identification, and personal patient search among others ("Briefings on Hospitals Safety," 2016). It is important for any organization to make these policies, processes, and procedures available so that every staff can easily reference them. They are some of the most important factors in any organization. STRATEGIC PLANNING 11 Conclusion The behavioral healthcare facility is one of the healthcare facilities that provide services to the population. However, many people avoid talking about these facilities. The clients visiting these facilities have different health issues. Currently, there are different ways in which people can assess these facilities to receive care. It is important for these facilities to describe their mission and vision statements so as to enable the population to learn about the services offered in these facilities and their goals. AA mission statement helps explain the facility’s plan of care and the expectations it has regarding its clients. On the other hand, the vision statement describes the plans the facility is making regarding its future. It has been found important for Philhaven to update its mission and vision statements so as to make them consistent with the current needs of the community. Its mission was found too broad while its vision is not concise enough. It is important for Philhaven to develop its mission and vision statements in such a way that potential clients will be able to read them and understand the kind of care provided in the facility. It is the role of the mission and vision statements to sell the organization. However, for Philhaven, these statements do not achieve that. Therefore, it is important for Philhaven to update both its mission and vision statements. STRATEGIC PLANNING 12 References Al-Sawai, A. (2013). Leadership of healthcare professionals: Where do we stand? Oman Medical Journal, 28(4), 285-287. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3725246/ Curran, C. (2015). Nurse on board: board basics...Chapter from a new STTI book. Reflections on Nursing Leadership, 41. Retrieved from www.reflectionsonnursingleadership.org Hem, M. H., Pedersen, R., Norvoll, R., & Molewijk, B. (2015). Evaluating clinical ethics support in mental healthcare: A systematic literature review. Nursing Ethics, 22, 452-466. http://dx.doi.org/10.1177/0969733014539783 Mental Health America. (2016). www.mentalhealthamerica.net Philhaven: Promoting hope, healing and wholeness. (2016). www.Philhaven.org Randolph, S. A. (2006, November). Developing policies and procedures. AAOHN Journal, 54, 501-504. Retrieved from Rihal, S. C. (2017). December. The importance of leadership to organizational success. NEJM Catalyst. Retrieved from https://catalyst.nejm.org/importance-leadership-skills- organizational-success/ Schroeder, R. T. (2014). February. AORN Journal, 99, 183-186. http://dx.doi.org/10.1016/j.aorn.2013.12.005 Strudwick, G., & Eyasu, T. (2015). Electronic health record use by nurses in mental health settings: A literature review. Archives of Psychiatric Nursing, 29, 238-241. http://dx.doi.org/10.1016/j.apnu.2015.03.007
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Outline
Introduction
Body
Conclusion
Reference


Strategic Visioning with
the Stakeholders
Presented by:
Date:

Background
• Philhaven is one of the behavioral health facilities located in Lancaster
County in Pennsylvania.

• The facility has a capacity of 103 beds.
• The health facility offers a wide range of services
• The services provided includes; outpatient services, inpatient services,
extended acute care, relationship counseling, day hospital services, employee
assistance programs, and group therapy

Practices







The facility engages in a lot of activities besides the services offered
Some of the activities include:

Coaching
Technology management
Management consulting

Courses

Mission of the facility
• The mission of Philhaven is to promote hope, healing, and wholen...


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