Unformatted Attachment Preview
Part A:
This part is already done. This part is the attached completed “Patient- and
Family-Centered Care Organizational Self-Assessment Tool” for my current practice
setting (which is a hospital setting).
Part A1: Provide appropriate description, with
sufficient detail to describe your current practice
setting.
[Instructor’s comments: The candidate does not provide an
appropriate description of the candidate’s current practice setting.
Criterion Score: 0.00
Comments on this criterion - The setting is described as a hospital.
Please describe this hospital in sufficient detail to understand this
setting.]
My current setting for patient- and Family-Centered Care is a hospital. This
hospital has medical doctors, qualified nurses, paramedics and health care specialists. The
hospital aim at providing quality patient and family care and enhance patient health. This
institutional setting offer stakeholders an opportunity to participate, collaborate, share
information as well as giving them dignity and respect during health care decision
making.
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Part A2:
Provide a plausible analysis, with substantial support of how patientand family-centered the evaluated organization is, based on the results from part A.
Analysis of the evaluated organization (my hospital):
The hospital has outlined an assessment of the most important aspects of providing
patient-centered care. The assessment has outlined up to eleven domains that are key to
providing quality patient care. During self-assessment, the analysis of these domains gave
the following results that can literally show how the hospital is patient- and familycentered in providing care:
1. Leadership operations: Leadership is important in a healthcare setting. The
present self assessment analyzed three most important elements of leadership
operations. The hospital scored 5 in both the statement of commitment and
accountability of patient client expectations. The hospital has explicitly
maintained these elements. However, the hospital scored 3 in the patient/family
inclusion during hospital policy making. This means that the institution should
work to ensure that patient and family as stakeholders is involved in policy
making during decision making.
2. Mission, Vision and Values: The hospital operates under clear mission, vision
and values as the first element and the second element, which is friendly Patient
Bill of Rights are clearly considered.
3. Advisors: With this domain the hospital scored poorly which means that patients
and family do not form part of the stakeholders that advice the hospital
management and leadership at any capacity.
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4. Quality Improvement: In this hospital, it is unlikely that patients and family will
participate in any quality improvement of the hospital that will help in providing
quality patient care.
5. Personnel: According to this assessment tool, patients in this hospital setting do
not participate in any hospital activity that aims at human resources management.
6. Environment and Design: This assessment shows that patient/family as
stakeholders do not participate in clinical practice and activities design and
environment activities design that help in improving patient care.
7. Information and Education: Out of the four elements of hospital information
source for patients, the internet and healthcare personal emails offer sufficient
information to patient. However, the patient/family serving as source of
information for healthcare professional is limited.
8. Diversity and Disparity: Since there are different communities served in the
hospital, this hospital provide interpreter services but does not perform excellent
in race, language, ethnicity and literacy levels of patient handling.
9. Charting and Documentation: The hospital does not provide assess or help to
chart and patient electronic and hard copy data to patients.
10. Care Support: Care and support is diverse. Out of the six elements of care
support in this assessment, 24/7 and patient medication history is provided.
Families stay in the hospital to care for members and rapid response systems is
rare. Apology for care or treatment errors is given but not excellent.
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11. Care: In this hospital, the four elements of patients: collaborative goal setting,
respect for clinician and patient, care transition from hospital to family and pain
management is sufficient.
Part A3:
Provide a logical discussion, with substantial detail, of gaps where the
organization could improve its patient- and family-centeredness, based on the
results from part A.
Gaps where this organization could improve its patient- and family- centeredness:
According to this assessment the hospital has specific areas that it will need to work
on in order to improve patient- and family- care centeredness. The following domains
scored low in hospital’s self assessment and need to improve:
Advisors: When analyzing the patient/family centered care, patient/family act as
stakeholders of the hospital and should participate in decision making (Eckle, MacLean,
2001). In the case of advising, the hospital should develop a strategy that patient/family
should offer direct advice to clinicians and hospital staff.
Quality improvement: Patient/family should be allowed to participate in developing
quality activities that aim at increasing quality patient care. Quality improvement
involves aligning duties and tasks within the hospital and among hospital staff. For
example, patients should be allowed to develop hospital visit schedule and health
professional’s shift.
Personnel: In this domain, hospitals do not allow patient/family to participate in human
resources hiring and management. Patient-centered services require that patient/family be
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allowed to participate in hiring and firing employees and general management of the
employees of the hospital.
Environment and Design:
Environmental and clinical design involves creating
strategies that enhance patient care that are not related to medication and treatment. For
example, the hospital does not include the patient/family in designing field visits and
studies of a specific health problem, which is contrary to what patient centered services
requires.
Charting and documentation: Although patient information is restricted information
that is not supposed to be retrieved and available, this hospital need to improve on giving
the patient their personal or family data when they require it. It is the goal of the hospital
to respect patients and give them their data when they require it.
Care Support: Several elements of care and support are a challenge to this hospital. The
hospital should improve on care support especially on family visits and stay in the
hospital, rapid response system that seems non existence in the hospital especially during
hospitalization.
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Part B: Provides a plausible analysis, with substantial
support, of how business practices and regulatory
requirements impact patient- and family-centered
healthcare.
[The candidate provides a plausible analysis, with no support, of how
business practices and regulatory requirements impact patient- and
family-centered healthcare.
Criterion Score: 1.00
Comments on this criterion: - There is a discussion of offering patient
care and providing quality services. A discussion of the business
practices and regulatory requirement that impact patient and
family centered care in healthcare needs expanded development.]
Impact on patient- and family-centered healthcare from business practice and
regulatory requirements:
In a hospital setting, stakeholders expect that a hospital only deal with treatment
and patient care. However, a hospital setting is more than Medicare treatment and
offering patient care. Treatment and patient care are achieved through business oriented
services (Castle, and Engberg, 2007). This means that, today’s hospital is a business
environment that seeks to provide quality services while enhancing profitability and
without affecting quality. For example, the hospital needs to hire quality human
resources; it needs to be located in a strategic location with targeted audience. The
hospital requires an effective supply chain for resources such as medical supplies and
medical equipment. Above all the hospital management needs to provide services that are
cost effective. This means that, all activities should be useful and accounted for without
wasting resources. A business oriented hospital will respond to the market trend such that
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if patients increase, the facility should increase its resources to cater for them. If the
hospital does not perform well, it should even include an analysis of strength,
opportunities, weaknesses and threats such that the particular hospital should remain an
investor of high quality patient- and family-centered health care services at cost effective
resources.
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Part C: Create a logical strategy, with substantial
detail, that includes goals and an operational plan to
increase patient-centeredness in the organization by
improving one of the gaps identified in part A3.
[The candidate does not create a strategy to increase patientcenteredness in the organization by improving 1 of the gaps identified
in part A3.
Criterion Score: 0.00
Comments on this criterion: - There is an extensive discussion
regarding the research that would take place. The strategy proposed is
to improve charting and documentation. However, whose charting is
going to be addressed as it relates to the self assessment tool is not
clearly identified. Please identify one strategy to address one of the
gaps from A3.]
Strategy that includes goals and an operational plan to increase patientcenteredness in the organization by improving one of the gaps:
Logical strategy to improve charting and documentation gap
Self assessment aims at providing guidelines on issues that require reinforcement so
as to enhance patient centered care. Logical factors that should be used to increase
patient-centeredness include the following as Bauer, (2007), highlights:
1. Identifying the gap problems: Through self assessment, the gaps that currently
reduce patient centeredness in a hospital will be identified.
2. Goals: increasing patient-centeredness require specific goals achievements. The
exercise and resources used to improve this healthcare aim at achieving the
following goals:
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•
Increase health services knowledge for both hospital staff and patient/family
members.
•
Ensure hospitals mission, vision and value achievement
•
Guarantee patient rights
3. Operational plan: operational plan to increase patient-centeredness care requires
a consideration on how the tasks will be achieved. This task will be achieved in
the following ways:
•
Conducting primary research to determine the impacts of the problems
identified in the self assessment form.
•
Choosing a research method and research tools that will assist in
conducting the primary research. In this case, separate focus groups that
will include patient/family and hospital staff will form the target groups
that will participate in primary research data collection.
•
Data analysis: data analysis will aim at determining issues that require
immediate attention and those that can be considered later. In other words,
data analysis will assist in prioritizing problematic issues.
4. Evaluation: Evaluation plan is critical when trying to find solution for a certain
problem. In this case, evaluation tools such as self assessment questionnaire and
interview will be used to collect data from patient/family to determine whether the
strategies used to improve patient-centeredness have been effective.
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Part C1: Provide a logical discussion, with
substantial detail, of the financial implications that
this strategy may have on the organization.
[The candidate provides a logical discussion, with no detail, of the
financial implications that this strategy may have on the organization.
Criterion Score: 1.00
Comments on this criterion:- There is an extensive discussion of
improving charting and hiring a data handling specialist as well as
conducting research. It remains unclear who is improving their
charting and how it reflects from the gaps of the self
assessment.]
Financial implications that this strategy may have on the organization:
Changing non-patient-centered gaps to patient-centeredness require resources.
Resources in terms of time, compensating for special skills will be required and finance
will be involved (Castle and Engberg, 2007). Charting & documentation require the use
of a data handling and data safety specialist.
•
Financial implication to pay salaries
There are several specialists who will be required to improve patient-centeredness.
For example, the data handling specialist may come from the system information
department within the hospital or even sourced from outside. If sourced from outside, the
specialist will be paid. For effective patient/family training, the hospital will need to
employ a resident specialist in order to serve all patients who attend the hospital because
patients need personalized services.
•
Finance to conduct research
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In addition to employing specialist services providers, the organization will spend
money to conduct primary research as part of the operation plan. Depending on the scope
of the research and scope of the problem gaps, the cost is expected to be high. For
example, the assessment highlight a number to gaps that need to be solved and if each
gap is to be solved independently.
•
Finance to acquire equipment
During patient-centeredness improving strategy, research results might indicate that
new equipment will be required to improve services. For example, these equipment
include computer systems that data specialist will either be using to train hospital staff or
buying more computers to improve data handling procedures in the hospital.
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Part C2: Identify appropriate potential members for a
multidisciplinary team who could assist you in
improving the identified gap.
[The candidate does not identify appropriate potential members for
a multidisciplinary team who could assist the candidate in improving
the identified gap.
Criterion Score: 0.00
Comments on this criterion: - An extensive team is proposed to
"improve patient centeredness". Please create a team to propose one
strategy.]
Potential members who could assist in improving the gap:
Improving patient-centeredness in hospitals requires a team that comprise of the
following multidiscipline experts:
•
Leadership nurse managers
•
Hospital management stuff including human resources manager
•
Social psychology counselors
•
Computer networking and systems experts
•
Personal coach
•
Statistician and
•
Ethics specialists
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Part C2a: Provide a logical discussion, with substantial
detail, of the purpose and scope of the team, including
team member roles.
[The candidate does not provide a logical discussion of the purpose
and scope of the team, including team member roles.
Criterion Score: 0.00
Comments on this criterion: - Once an appropriate strategy is
identified, the purpose and scope of the team will be better
evaluated.]
Purpose and scope of the team, including team member roles:
The team members that will improve patient-centered services will require
different disciplines because of different elements that aim at combining different
knowledge to achieve a common goal. For example, the experts in data handling will
bring in their expertise to train hospital staff on both digital and traditional hardcopy
handling. The training will include a highlight of how misuse of patient data can result to
legal actions whether the person handling such data is aware of the problems that can
arise from data handling (AHRQ, 2014). Therefore, since trying to increase hospital
patient-centered care will involve different disciplines, the hospitals should source
different personnel with specialist skills to help in training or work in order to streamline
patient-centered services in the chosen health facility.
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Part C2b: Provide a logical discussion, with substantial
support of the importance of diversity within the team
to support patient-centered care.
[The candidate does not provide a logical discussion of the
importance of diversity within the team to support patient-centered
care.
Criterion Score: 0.00
Comments on this criterion: - Diversity within a team is discussed
clearly. Once an appropriate strategy is identified, this aspect will
be better evaluated.]
The importance of diversity within the team:
Diversity in the team means that having different staff or trainers with diverse
qualification and experience to help in providing different training and knowledge to help
in streamlining patient care. Different trainers with different skills and experience will
address specific challenges and opportunities rather than having a common management
that seldom address specific issues. For example, health data handling expert will provide
knowledge about the importance of patient data safety and a networking expert will teach
those handling electronic data on how to use the data control system that aim at
increasing security for online patient data (AHRQ, 2014). Importance of diversity means
that giving all the problems currently faced in the health institution that will prevent
providing patient centered data will be addressed.
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Part C2c: Provide a plausible analysis, with substantial
detail, of the specific tools you could use to facilitate the
team in a meaningful way, including self-assessment,
awareness, and self-reflection techniques.
[The candidate does not provide a plausible analysis of the specific
tools to use to facilitate the team in a meaningful way, including selfassessment, awareness, and self-reflection techniques.
Criterion Score: 0.00
Comments on this criterion: - The specific tools that will facilitate
self assessment, awareness and self reflection are not identified.]
Specific tools that can be used to facilitate the team, including self-assessment,
awareness, and self-reflection techniques:
In trying to streamline patient centered care in a hospital, specific tools that will be
used is providing training equipment such as a digital platform include providing
personal computers fitted with specific learning software so that hospital staff can get
training without having to affect their daily tasks. Digital learning as opposed to physical
learning has been used in trying to offer fresh knowledge to employee of any
organization. In addition to offering learning tools, the hospital will also need to provide
competent assessment tool that will act as way of self appraisal (Castle and Engberg,
2007). The competent and self assessment tool after analysis will help in identifying
employee weakness in order to develop customized training solutions. Employees will
have different strengths and weaknesses and is better to develop maximize and maintain
strength and develop strategies that will enhance elevate weakness. Weakness does not
necessary mean that employees do not have knowledge to complete a certain task.
Employees may indicate external forces that might be affecting their performance and
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through effective communication and effective leadership, the challenges will have a
ready solution.
Part C3: Provide a logical discussion, with substantial
detail, of the metrics you could use to monitor whether
your strategy is effective in increasing patient-centered
care.
[The candidate does not provide a logical discussion of the metrics
to use to monitor whether the strategy is effective in increasing
patient-centered care.
Criterion Score: 0.00
Comments on this criterion: - Once a specific strategy is identified
from the gaps identified, the metrics to evaluate their success will
be better evaluated.]
Metrics that could be used to monitor the effectiveness of the strategy in increasing
patient-centered care:
Evaluation of the used strategies in solving a particular problem is essential. In this
project, evaluation will involve monitoring specific element of domains of the Patientand Family-Centered Care Organizational Self-Assessment Tool that had low score
during completion. During solution monitoring, the following specific metric will
indicate whether the strategies used were successful or not according to (Johnson, 2000):
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Patient care change: through Patient- and Family-Centered Care Organizational SelfAssessment Tool patient domains and their elements should be able to score high in on
the scale.
Accessing measure: when trying to streamline patient-centered care, accessing measure
is essential in order to outline the strategies used. These strategies should be specific to
patient care in health institutions so as not to use strategies that are not resourceful.
Patient experience measure: In an attempt to improve patient care, it is important to
access the patient/family client satisfaction so as to determine the effectiveness of the
change. If customers do not appreciate the changes, then these changes were not made to
serve them. Otherwise the general program of hospital self-assessment is to find solutions
for challenges in order to improve healthcare services.
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References
Agency for Healthcare Research and Quality. (2014). System Metrics. A Toolkit
Redesign in Health Care: Final Report. US Department of Health & Human
Services. Retrieved on August 23, 2014 from
http://www.ahrq.gov/professionals/quality-patient-safety/patient-safetyresources/resources/toolkit/toolkit6.html
Bauer, R.M (2007). Evidence-based practice in psychology: Implications for research and
research training. Journal of Clinical Psychology. 63 (7): 685-694.
Castle, N. G. and Engberg, J. (2007). The Influence of Staffing Characteristics on Quality
of Care in Nursing Homes. Health Services Research.42. (5): 1822-1847.
Eckle, N., MacLean, S.L. (2001). Assessment of family-centered care policies and
practices for pediatric patients in nine US emergency department. Journal of
Emergency Nursing. 27 (3):238-245.
Johnson, B. H. (2000).Family-centered care: Four decades of progress. Families,
Systems, & Health. 18 (2): 137-156
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