Revise an Assignment Related to Nursing

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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. 1 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. 2 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. 3 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 4 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. 5 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 6 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. 7 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: 8 • 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. 9 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 10 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. 11 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 12 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. 13 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. 14 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 15 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): 16 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. 17 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 18
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