WGU UOT TASK 1 ORGANIZATIONAL LEADERSHIP AND INTERPROFESSIONAL TEAM DEVELOPMENT

WGU UOT TASK 1 ORGANIZATIONAL LEADERSHIP AND INTERPROFESSIONAL TEAM DEVELOPMENT

WGU UOT TASK 1 ORGANIZATIONAL LEADERSHIP AND INTERPROFESSIONAL TEAM DEVELOPMENT

WGU Performance Assessment 12/8/19, 8(40 PM UOT2 — UOT TASK 1 ORGANIZATIONAL LEADERSHIP AND INTERPROFESSIONAL TEAM DEVELOPMENT — C158 PRFA — UOT2

COMPETENCIES

7006.01.01 : Leadership Concepts and Theories The graduate evaluates leadership practices that support accountability and integrity within an organization.

7006.01.02 : Systems Theory and Change Theory The graduate relates systems theory and change theory to the design, delivery, and evaluation of healthcare. WGU UOT TASK 1 Organizational Leadership And Interprofessional Team Development

7006.01.03 : Role Development and Effective Interprofessional Teams The graduate analyzes effective leadership strategies within the context of the interprofessional team.

7006.01.04 : Business and Economic Principles and Practices The graduate identifies the impact of business and economic principles and practices, and regulatory requirements on the provision of healthcare.

7006.01.05 : Contemporary Healthcare Leadership Issues The graduate analyzes the impact of contemporary healthcare trends and practices on the delivery of healthcare.

INTRODUCTION

Healthcare is a complicated system that includes unique economic processes, regulatory requirements, and quality indicators that are not found in traditional business settings. Therefore, developing unique skill sets relating to organizational leadership and interprofessional team development is essential for leaders within the healthcare industry at any level. As the complexity within the healthcare industry increases, it is important to understand the comprehensive approach to patient care management across the continuum and how the concepts of organizational leadership and team development support leaders in creating a patient-centric environment.

The purpose of this assessment is to provide a framework through which you can experience and understand the unique leadership concepts within healthcare and understand the implications of business and regulatory requirements in providing patient-centered care. You will use a system theory or a change theory, self-assessment tools, and team development concepts to design a strategy to increase patient-centered care. Using leadership concepts and theories, you will ensure a sustainable model of healthcare delivery throughout the changing healthcare system that considers future trends, evidencehttps://tasks.wgu.edu/student/000263647/course/4200008/task/1083/overview Page 1 of 8 WGU Performance Assessment 12/8/19, 8(40 PM based practice, and regulatory expansion. WGU UOT TASK 1 Organizational Leadership And Interprofessional Team Development

For this assessment, you will use the attached “Patient-and Family-Centered Care Organizational Self Assessment Tool,” to analyze how patient- and family-centered the healthcare setting is. This form will guide you in evaluating this healthcare setting for strengths and weaknesses in patient-centered care attributes. Based on your analysis, you will create a strategy to improve patient-family-centered care.

REQUIREMENTS – WGU UOT TASK 1 ORGANIZATIONAL LEADERSHIP AND INTERPROFESSIONAL TEAM DEVELOPMENT

Your submission must be your original work. No more than a combined total of 30% of the submission and no more than a 10% match to any one individual source can be directly quoted or closely paraphrased from sources, even if cited correctly.

An originality report is provided when you submit your task that can be used as a guide. You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course. Professional Communications is a required aspect to pass this task. Completion of a spell check and grammar check prior to submitting your final work is strongly recommended.

Note: Any information that would be considered confidential, proprietary, or personal in nature should not be included. Do not include the actual names or other personally identifiable information of people or stakeholders involved. Fictional names should be used. Also, agency-specific data, including any financial information, should not be included but should be addressed in a general fashion as appropriate. A. Analyze how business practices, regulatory requirements, and reimbursement impact patient-family centered care within a healthcare organization.

B. Complete the attached “Patient-and Family-Centered Care Organizational Self-Assessment Tool” (PFCC) for a healthcare organization. Note: The PFCC tool is a subjective tool used to assess the organization you have chosen. 1. Describe the healthcare setting you used in the PFCC. Note: Please include the type of facility, the services provided by the facility and the diverse ethnic groups cared for by the facility.

2. Using the completed PFCC tool, describe the strengths and weaknesses of the organization for each domain. C. Identify one area of improvement from the weaknesses identified in part B2.

1. Create a strategy to increase patient-centeredness in the organization by addressing the weakness from part C. a. Discuss how you would apply either system theory or change theory in the development of https://tasks.wgu.edu/student/000263647/course/4200008/task/1083/overview Page 2 of 8 WGU Performance Assessment 12/8/19, 8(40 PM your strategy to address the chosen weakness.

Note: The strategy should include the development of a multi-disciplinary team and how patient family centered care can be improved.

2. Discuss the financial implications of implementing this strategy.

3. Discuss the methods you will use to evaluate the effectiveness of your strategy.

D. Create a multidisciplinary team by identifying the following:

• potential members that will assist you in implementing the identified strategy

• The role of each team member

1. Discuss how cultural diversity within the team supports patient-centered, culturally competent care.

2. Using one of the leadership theories below, discuss the leadership style you would utilize in developing your team:

• transactional leadership

• transformational leadership

• emotional leadership

• traditional leadership

3. Discuss how the team will work together to implement the strategy to address the weakness identified in part C1.

4. Describe how the team will communicate the identified strategy and intended outcomes to the healthcare organization.

5. Describe a specific tool you could use to develop the team’s self-assessment skills.

E. Acknowledge sources, using APA-formatted in-text citations and references, for content that is quoted, paraphrased, or summarized. WGU UOT TASK 1 Organizational Leadership And Interprofessional Team Development

RUBRIC

ARTICULATION OF RESPONSE (CLARITY, ORGANIZATION, MECHANICS): NOT EVIDENT COMPETENT The candidate provides unsat- APPROACHING COMPETENCY isfactory articulation of The candidate provides weak quate articulation of response. response. articulation of response. The candidate provides ade- A. BUSINESS PRACTICES : NOT EVIDENT The analysis of how business APPROACHING COMPETENCY

https://tasks.wgu.edu/student/000263647/course/4200008/task/1083/overview COMPETENT The analysis includes how busiPage 3 of 8 WGU Performance Assessment 12/8/19, 8(40 PM practices, regulatory require- The analysis does not include ness practices, regulatory re- ments, and reimbursement im- how business practices, regula- quirements, and reimbursement pact patient-centered care is tory requirements, or reim- impact patient centered care not provided or is fundamen- bursement impact patient-cen- within a healthcare tally unacceptable. tered care within a healthcare organization. organization. WGU UOT TASK 1 ORGANIZATIONAL LEADERSHIP AND INTERPROFESSIONAL TEAM DEVELOPMENT

  1. SELF-ASSESSMENT TOOL: NOT EVIDENT

The completed PFCC is not APPROACHING COMPETENCY provided or is fundamentally Not applicable. COMPETENT The PFCC is complete. unacceptable. B1. SETTING DESCRIPTION: NOT EVIDENT COMPETENT The description of the health- APPROACHING COMPETENCY care setting is not provided or The description is missing in- picts the healthcare setting is fundamentally unacceptable. formation about the healthcare used for the PFCC, including the setting used for the PFCC, in- population served and facility cluding the population served, type. The description is clear facility type, or the community. and logical. The description thoroughly de- The description may be unclear or may contain some information that is impractical or illogical.

B2. STRENGTHS AND WEAKNESSES: NOT EVIDENT COMPETENT

The description of the APPROACHING COMPETENCY strengths and/or weaknesses The description is missing at fies the strengths and/or weak- for each domain is not provided least one strength and/or nesses of the healthcare organi- or is fundamentally weakness of the healthcare or- zation for each domain using unacceptable. ganization for at least one do- the PFCC. The description is main. Or the description does clear and logical https://tasks.wgu.edu/student/000263647/course/4200008/task/1083/overview The description precisely identi- Page 4 of 8 WGU Performance Assessment 12/8/19, 8(40 PM not use the completed PFCC. The description may be unclear or may contain some illogical information about the strengths or weaknesses. WGU UOT TASK 1 ORGANIZATIONAL LEADERSHIP AND INTERPROFESSIONAL TEAM DEVELOPMENT

  1. AREA OF IMPROVEMENT: NOT EVIDENT COMPETENT

The identification of 1 area of APPROACHING COMPETENCY improvement is not provided The identification area of im- tified from the weaknesses or is fundamentally provement is not relevant to identified in part B2. The selec- unacceptable. the weaknesses identified in tion is presented clearly and is part B2. The selection may be logical. An area of improvement is iden- unclear or contain information that is impractical or illogical.

C1. IMPROVEMENT STRATEGY: NOT EVIDENT COMPETENT

The strategy to increase pa- APPROACHING COMPETENCY tient-centeredness is not pro- The strategy is missing infor- tient-centeredness could be in- vided or is fundamentally mation about how patient-cen- creased, the strategy is relevant unacceptable. teredness could be increased, to the PFCC tool, and the strat- the strategy is not relevant to egy focuses on improving the the PFCC tool, or the strategy identified weakness. The strategy includes how pa- does not focus on improving the identified weakness.

C1A. SYSTEM OR CHANGE THEORY : NOT EVIDENT COMPETENT

The description of how the APPROACHING COMPETENCY candidate would apply a strate- The description is missing in- the candidate would apply the gy using system or change the- formation about how the can- strategy. The description in- ory is not provided or is funda- didate would apply the strate- cludes how the strategy would mentally unacceptable. gy. Or the description does not address the chosen weakness. include how the strategy would The description uses either sys- address the chosen weakness. tem theory or change theory. WGU UOT TASK 1 ORGANIZATIONAL LEADERSHIP AND INTERPROFESSIONAL TEAM DEVELOPMENT https://tasks.wgu.edu/student/000263647/course/4200008/task/1083/overview The description includes how Page 5 of 8 WGU Performance Assessment 12/8/19, 8(40 PM Or the description does not use either system theory or change theory.

C2. FINANCIAL IMPLICATIONS: NOT EVIDENT COMPETENT

The discussion of financial im- APPROACHING COMPETENCY plications is not provided or is The discussion is illogical or un- dresses the financial implica- fundamentally unacceptable. related to the strategy or is tions that the strategy may have missing information about how on the organization The discussion precisely ad- the financial implications may impact the organization.

C3. METHODS: NOT EVIDENT COMPETENT

The discussion of the methods APPROACHING COMPETENCY used to monitor the effective- The discussion is illogical or is clearly addresses how the ness of the strategy is not pro- missing information about how methods will be used to evalu- vided or is fundamentally the methods will be used to ate the effectiveness of the unacceptable. evaluate the effectiveness of strategy in increasing patient- the strategy in increasing patient-centered care.

  1. MULTIDISCIPLINARY TEAM: NOT EVIDENT COMPETENT

The identification of team APPROACHING COMPETENCY members and their specific The identification of the multi- disciplinary team members and roles is not provided or is fun- disciplinary team members and their specific roles on the team damentally unacceptable. their specific roles on the team in assisting in implementing the in assisting in implementing the strategy is relevant and logical. The identification of the multi- strategy is unclear or unrelated to the strategy.

D1. TEAM DIVERSITY : NOT EVIDENT APPROACHING COMPETENCY

https://tasks.wgu.edu/student/000263647/course/4200008/task/1083/overview COMPETENT Page 6 of 8 WGU Performance Assessment 12/8/19, 8(40 PM The discussion of the impor- The discussion of the impor- The discussion logically ad- tance of cultural diversity with- tance of cultural diversity with- dresses the importance of cul- in the team is not provided or is in the team is missing informa- tural diversity within a team, in- fundamentally unacceptable. tion about representation or cluding representation and in- about how cultural diversity cluding how cultural diversity within the team supports pa- within a team supports patient- tient-centered, culturally com- centered, culturally competent petent care. care.

COMPETENT The discussion of the leader- APPROACHING COMPETENCY ship style utilized to develop The discussion of the leader- style utilized in developing the the team is not provided or is ship style utilized in developing team uses one of the given lead- fundamentally unacceptable. the team is missing information ership theories and is relevant about the chosen leadership to implementing the identified theory or is missing informa- strategy. WGU UOT TASK 1 Organizational Leadership And Interprofessional Team Development

D2.LEADERSHIP THEORIES : NOT EVIDENT

The discussion of the leadership tion about how the leadership style is relevant to implementing the identified strategy. D3. IMPLEMENTATION OF STRATEGY: NOT EVIDENT COMPETENT The discussion of how the team APPROACHING COMPETENCY collaboratively implements the The discussion of how the team steps to collaboratively imple- strategy is not provided or is will collaboratively implement ment the strategy, including fundamentally unacceptable. the strategy is illogical or does team member and individual re- not include how the team will sponsibilities, and is relevant to work together or is not rele- the weakness identified in the vant to the weakness identified PFCC. The discussion clearly identifies in the PFCC.

D4. COMMUNICATION TO ORGANIZATION: NOT EVIDENT COMPETENT

The description of how the APPROACHING COMPETENCY team will communicate the The description is unclear or is will communicate the strategy https://tasks.wgu.edu/student/000263647/course/4200008/task/1083/overview The description of how the team Page 7 of 8 WGU Performance Assessment 12/8/19, 8(40 PM strategy and outcomes is not missing information about how and intended outcomes to the provided or is fundamentally the team will communicate the healthcare organization is logi- unacceptable. strategy or intended outcomes cal and clear. to the organization. WGU UOT TASK 1 ORGANIZATIONAL LEADERSHIP AND INTERPROFESSIONAL TEAM DEVELOPMENT

D5. TOOLS FOR THE TEAM: NOT EVIDENT COMPETENT

The description of the self-as- APPROACHING COMPETENCY sessment tool for the team is The description of the specific tool is provided and identifies not provided or is fundamen- tool is unrelated to or is miss- how the tool will help the team tally unacceptable. ing information about how the develop self-assessment skills. The description of the specific tool will help the team develop self-assessment skills.

  1. SOURCES: NOT EVIDENT COMPETENT

The submission does not pro- APPROACHING COMPETENCY vide in-text citations and refer- The submission includes in-text citations and references and ences according to APA style. citations and references but demonstrates a consistent ap- does not demonstrate a consis- plication of APA style. The submission includes in-text tent application of APA style. SUPPORTING DOCUMENTS Patient-and Family-Centered Care Organizational Self-Assessment Tool.pdf https://tasks.wgu.edu/student/000263647/course/4200008/task/1083/overview Page 8 of 8 Running head:

ORGANIZATIONAL LEADERSHIP Patient Family Centered Care Western Governors University Organizational Leadership and Interprofessional Team Development C158 Patient Family Centered Care 1 Organizational Leadership 2 Business Practices This section is asking for you to provide analysis that includes how (1) business practices, (2) regulatory requirements, and (3) reimbursement impact patient centered care within a healthcare organization. Make sure you tie these back to how they impact patient / family centered care. WGU UOT TASK 1 Organizational Leadership And Interprofessional Team Development

A well developed paragraph for each is recommended. This section does not need to be specific to your organization. The business practices of today’s healthcare functions many working facets, which must meet specific guidelines when it comes to any patient care. A healthcare systems base its policy and practices on the DNV Accreditation policies and safety requirements, such as nurse to patient staffing ratios, the types of caregivers, the fulfillment of patient needs as measured by polling companies like Press Ganey, community relations, and adherence to state laws. These requirements are the basis with which healthcare organization functions. WGU UOT TASK 1 ORGANIZATIONAL LEADERSHIP AND INTERPROFESSIONAL TEAM DEVELOPMENT

The patient and family centered care ideal is impacted by how these requirements are utilized. Patient and Family Centered Care Tool (PFCC) Please see attached document for completed PFCC Tool. (This allows the evaluator to know that you have uploaded the tool and to look at it in a separate attachment. The tool must be complete and attached.) Setting Description The description should thoroughly depict the healthcare setting used for the PFCC, including the population served and facility type.

The description should be clear and logical. Consider facility size, types of care provided, age of facility, etc. This is the section in which Organizational Leadership 3 you are going to talk about your organization. Make sure you describe the community and the population that the facility serves. It does not have to be lengthy (1-2 paragraphs is sufficient). (Note: Because this task requires the creation of an interdisciplinary healthcare team, it is imperative that you choose a “healthcare facility” as your organization.

If your place of employment does not meet this criteria, it is not a problem – you will just need to reach out to your assigned CM for assistance in determining the organization you will use. ) Strengths and Weaknesses of the Organization In this section you will identify and briefly describe the strength and weakness for each of the 11 domains from the PFCC tool. You may want to write a paragraph about each domain, using each domain as a subheading. Make sure the scores you gave the elements in the PFCC assessment tool match the narrative. If you rate all elements of one domain as a “5” you need to state, “no weaknesses identified”.

You may want to create a table such as the one included below: Domain Leadership/Operations Mission, Vision, Values Advisors Quality Improvement Personnel Environment & Design Strength Weakness Organizational Leadership 4 Information/Education Diversity & Disparities Charting & Documentation Care Support Care Area of Improvement An area of improvement is identified from the weaknesses identified in part B2. The selection is presented clearly and is logical. You are to choose one element in one domain that you are going to choose to develop as your strategy. Improvement Strategy In this section you will provide a broad overview of the strategy you are going to use to address the area of improvement identified in section C above. WGU UOT TASK 1 ORGANIZATIONAL LEADERSHIP AND INTERPROFESSIONAL TEAM DEVELOPMENT

Patient- and Family-Centered Care Organizational Self-Assessment Tool

Elements of Hospital-Based Patient- and Family-Centered Care (PFCC) and
Examples of Current Practice with Patient and Family (PF) Partnerships

Domain Element1 Low to High Do not

know

Leadership /

Operations

Clear statement of commitment to Patient Family

Centered Care and Patient/Family partnerships

1 2 3 4

x

5
Explicit expectation, accountability, measurement of

Patient Family Centered Care

1 2 3

x

4 5
Patient/Family inclusion in policy, procedure, program,

guideline development, Governing Board activities

1 2

x

3 4 5
Mission,

Vision, Values

Patient Family Centered Care included in Mission, Values,

and/or Core Values

1 2 3

x

4 5
Patient/Family “friendly” Patient Bill of Rights and

Responsibilities

1 2 3 4 5

x

Advisors Patient/Family serve on hospital committees 1

x

2 3 4 5
Patient/Family participate in quality and safety rounds 1 2

x

3 4 5
Patient and family advisory councils 1

x

2 3 4 5
Quality

Improvement

Patient/Family voice informs strategic / operational

aims/goals

1

 

2 3

x

4 5
Patients/Families active participants on task forces, QI

teams

1

x

2 3 4 5
Patient/Family interviewed as part of walk-rounds 1 2

x

3 4 5
Patient/Family participate in quality, safety, and risk

meetings

1

x

2 3 4 5
Patient/Family part of team attending IHI, NPSF, and

other meetings

1 2

x

3 4 5
Personnel Expectation for collaboration with Patient/Family in job

descriptions & Policies in Performance Appraisal Process

1 2

x

3 4 5
Patient/Family participate on interview teams, search

committees WGU UOT TASK 1 ORGANIZATIONAL LEADERSHIP AND INTERPROFESSIONAL TEAM DEVELOPMENT

1

x

2 3 4 5
Patient/Family welcome new staff at new employee

orientation

1

x

2 3 4 5
Staff/physicians prepared for & supported in

Patient/Family Centered Care practice

1 2 3 4 5

x

Environment

And Design

Patient/Family participate fully in all clinical design

projects

1

x

2 3 4 5
Environment supports patient and family presence and

participation as well as interdisciplinary collaboration

1 2 3 4 5

x

 

 

1 Codes: PFCC=Patient- and Family-Centered Care; PF=Patient and Family; PAS= Performance Appraisal System

 

 

Institute for Healthcare Improvement and the National Initiative of Children’s Healthcare Quality,

developed in partnership with the Institute for Family-Centered Care                                                                                                                                                       Page 1

 

Patient- and Family-Centered Care Organizational Self-Assessment Tool

Elements of Hospital-Based Patient- and Family-Centered Care (PFCC) and
Examples of Current Practice with Patient and Family (PF) Partnerships

 

Domain Element2 Low                       High

Do not

know

Information /

Education

Web portals provide specific resources for Patient/Family 1 2 3 4

x

5
Clinician email access from PF is encouraged and safe 1 2 3 4

x

5
Patient/Family serve as educators/faculty for clinicians and other staff. WGU UOT TASK 1 ORGANIZATIONAL LEADERSHIP AND INTERPROFESSIONAL TEAM DEVELOPMENT 1 2 3 4

x

5
Patient/Family access to / encouraged to use resource

rooms

1 2 3 4

x

5

 

 

 

Domain Element3 Low                                        High Do not

know

Diversity &

Disparities

Careful collection and measurement; race / ethnicity /

language

1 2 3 4

x

5
Patient/Family provided timely access  to interpreter

services

1 2 3 4

 

x

5
Navigator programs for minority and underserved patients 1 2

x

3 4 5
Educational materials at appropriate literacy levels 1 2

x

3 4 5
Charting and

Documentation

Patient/Family have full and easy access to

paper/electronic record

1 2 3 4

x

5
Patient and family are able to chart 1

x

2 3 4 5
Care Support Families members of care team, not visitors, with 24/7

access

1

x

2 3 4 5
Families can stay, join in rounds & change of shift report 1 2 3 4 5

x

Patient/Family find support, disclosure, apology with error

and harm

1

x

2 3 4 5
Family presence allowed/ supported during rescue events 1 2 3

x

4 5
Patient/Family are able to activate rapid response systems 1

x

2 3 4 5
Patients receive updated medication history at each visit 1 2 3 4

x

5

 

2 Codes: PFCC=Patient- and Family-Centered Care; PF=Patient and Family; PAS= Performance Appraisal System

3Codes: PFCC=Patient- and Family-Centered Care; PF=Patient and Family; PAS= Performance Appraisal System. WGU UOT TASK 1 ORGANIZATIONAL LEADERSHIP AND INTERPROFESSIONAL TEAM DEVELOPMENT

 

Institute for Healthcare Improvement and the National Initiative of Children’s Healthcare Quality,

developed in partnership with the Institute for Family-Centered Care                                                                                                                                                       Page 2

 

Patient- and Family-Centered Care Organizational Self-Assessment Tool

Elements of Hospital-Based Patient- and Family-Centered Care (PFCC) and
Examples of Current Practice with Patient and Family (PF) Partnerships. WGU UOT TASK 1 Organizational Leadership And Interprofessional Team Development

 

Domain Element4 Low                                        High Do Not

Know

Care Patient/Family engage with clinicians in collaborative goal

setting

1 2 3

x

4 5
Patient/Family listened to, respected, treated as partners

in care

1 2 3

x

4 5
Actively involve families in care planning and transitions 1 2 3

x

 

 

4 5
Pain is respectively managed in partnership with patient

and family. WGU UOT TASK 1 ORGANIZATIONAL LEADERSHIP AND INTERPROFESSIONAL TEAM DEVELOPMENT

1 2 3

x

4 5

 

4Codes: PFCC=Patient- and Family-Centered Care; PF=Patient and Family; PAS= Performance Appraisal System

 

Institute for Healthcare Improvement and the National Initiative of Children’s Healthcare Quality,

developed in partnership with the Institute for Family-Centered Care                                                                                                                                                       Page 3

Organizational Leadership and Interprofessional Team Development Sample

Business Practices

 

The healthcare industry is ever-changing, and the latest focus is around patient-family centered care.  Healthcare organizations are now working to the Triple Aim. The Triple Aim looks at improving the patient experience of care (including quality and satisfaction), improving the health of the community population and reducing the per capita cost of healthcare (Rousel, 2016). Patient-family centered care moves the patient and family to the forefront of the care team and allowing them to have an active role in the decision making of the patient’s care. This change works to improve the relationship between the physicians, care team, patient, and family and improve the patients overall care experience. Involving the patient and family in the care decision making supports the wellbeing of the patient physically but psychologically as well.

Changes to policies and procedures including patient care protocols must be made to ensure the patient and family are an active part of the patients care. Some of these changes are more open and longer visitation hours and allowing a healthcare representative to stay with the patient 24/7 in the intensive care units. Patients and families are also given to opportunity to provide feedback on their healthcare experience. The hospitals use the feedback provided to continue to make changes and improve the care provided. WGU UOT TASK 1 Organizational Leadership And Interprofessional Team Development

Regulatory bodies such as Centers for Medicare and Medicaid Services (CMS) and the Joint Commission (JACHO) as well as many others set healthcare standards and regulations to ensure that organizations provide safe care to patients. Many of these regulatory bodies have set requirements that the healthcare organization must include patient-family centered care as well as patient safety in their mission. In 2010, the Affordable Care Act was passed with the intention of providing more affordable and easier accessible care to all. With the passing of this act, healthcare organizations are now to pushed to provide safe, quality care while working to save costs at the same time.

These regulatory bodies can also use the regulation and standards set to affect the reimbursements received based on the care provided to patients. Hospitals are no longer reimbursed solely on the quantity of care services they provide but also on the quality of services provided. CMS initiated the Value-Based Purchasing program that rewards healthcare organizations for the quality care they provide to Medicare patients.

The HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey from CMS, is the first publicly reported survey of patients’ perspectives of hospital care. CMS publishes participating hospitals’ HCAHPS scores four times a year. The Patient Protection and Affordable Care Act includes HCAHPS in its measure used to calculate value-based incentive payments in the Hospital Value-Based Purchasing program (CMS, 2017). WGU UOT TASK 1 ORGANIZATIONAL LEADERSHIP AND INTERPROFESSIONAL TEAM DEVELOPMENT

Patient and Family Centered Care Tool (PFCC)

Please see separately attached document for completed PFCC Tool.

Setting Description

The health care setting is a local, not-for-profit general and acute care facility with 435 inpatient beds as well as 46 primary and specialty physician offices (CaroMont Health, 2019). This hospital is just off a busy interstate in a rapidly growing area. The facility is a Level III Trauma Center, has 27 critical care beds, several monitored-telemetry units, medical-surgical, a neurological unit, orthopedic unit, psychiatric unit for pediatric and adult patients and a pediatric ER. In 2018, Gaston County had a population of around 222,000 residents containing a diverse mix of ethnic groups from Caucasians, African Americans, and Hispanics with 94.6% being US citizens. WGU UOT TASK 1 ORGANIZATIONAL LEADERSHIP AND INTERPROFESSIONAL TEAM DEVELOPMENT

In Gaston County, 84.1% of the population 25 years of age and older have a high school diploma or higher and 20.5% have a bachelor’s degree or higher. The median household income in 2017 was $46,626 with 15.1% of the population leaving at or below the national poverty level (Census, 2018). WGU UOT TASK 1 Organizational Leadership And Interprofessional Team Development

Strengths and Weaknesses of the Organization

Domain Strength Weakness
Leadership/Operations Commitment to the patient- and family-centered care is clearly stated with set expectations.

 

The patient is always included in the development of policies and procedures but not always the family.
Mission, Vision, Values Mission, Vision, Values promotes a collaborative approach to care for the entire community. Patient Bill of Rights clearly posted throughout the hospital for patients and families. WGU UOT TASK 1 ORGANIZATIONAL LEADERSHIP AND INTERPROFESSIONAL TEAM DEVELOPMENT

 

Again, although the patient is at the forefront of the mission, vision the family is not always taken into account.
Advisors Staff is encouraged to include patient and families in their beside rounding and shift report. WGU UOT TASK 1 Organizational Leadership And Interprofessional Team Development

 

Although there is one committee that includes the community, patients and families do not serve on most advisory councils at the hospital.
Quality Improvement Patients and families are rounded on by unit leadership and input are considered for operational goals.

 

Patients and families are not active members of council meetings or quality improvement projects.
Personnel Patient- and family-centered care is an expectation in all patient care job roles. The staff engages patients and families in care and education.

 

Patients and families are not involved in the hiring or orientation process…
Environment & Design The environment supports family presence during the hospital stay with open visitation hours.

 

Patients and families do not typically participate in clinical design projects.
Information/Education Patient web portals and resources are easy to navigate and email communication with providers is encouraged.

 

Patient and families are not utilized to their fullest capabilities as educators on their specific conditions.
Diversity & Disparities 24-hour access available for face to face interpreters using an application via iPad.

 

Staff is not able to change the literacy level for education materials provided to patients and families.
Charting & Documentation Patients and families have access to their records via “My Chart” and encouraged to review their records frequently.

 

Patients can mark medications for removal via “My Chart” but can not chart in their patient record.
Care Support Families can activate a rapid response if they feel immediate care is warranted. WGU UOT TASK 1 Organizational Leadership And Interprofessional Team Development

 

Families are often times not included in the bedside shift report process.
Care Patients and families are treated as partners in the care team. Families are involved in transition planning for patients at discharge.

 

Pain is a hot topic and is managed to the best of the staff’s ability but often times complete pain relief is unachievable.

 

Area of Improvement

After reviewing the PFCC tool, the area of improvement I choose to focus is within the care domain and including patients and families in the report at shift change. Lack of communication and knowledge of the patient’s plan of care is a reoccurring them on survey’s sent out by hospitals at discharge. In order to continue the movement of patient- and family-centered care, both patients and families would benefit from being included in the sharing of information regarding the patient’s plan of care. CaroMont Regional Medical Center sets the expectation for nurses to conduct their shift report at the bedside.  Although the nurses do exchange information regarding their patients at the patient’s doorway, the patients and families are not always included in the exchange of information. Involving the patients and families would also provide the patient and family the opportunity to identify any discrepancies or incorrect health information being sharing. WGU UOT TASK 1 ORGANIZATIONAL LEADERSHIP AND INTERPROFESSIONAL TEAM DEVELOPMENT

Improvement Strategy

In order to patient and family involvement in the sharing of information at shift change, I intend to implement standard work for bedside shift report. The standard work will give step by step instruction of how the bedside shift report should be conducted. At shift change the two nurses would enter the patient’s room, acknowledging all patient and family if present, the oncoming nurse would introduce their self to the patient and family. A brief overview of the patient’s history, labs and tests will be reviewed from the electronic medical record (EMR) and events of the shift should be reported.

A review of the patient’s physical assessment including tracing any IV lines from bag to patient will be conducted at this time. The patient and family should be allowed to ask any questions regarding their plan of care answered throughout the bedside report. The oncoming nurse will update the whiteboard with up to date information for the new shift as well as their SpectraLink phone number. After the report is complete and all questions answered, the off going nurse will enter this encounter in the patient’s EMR in the nurse handoff flowsheet. WGU UOT TASK 1 ORGANIZATIONAL LEADERSHIP AND INTERPROFESSIONAL TEAM DEVELOPMENT

System or Change Theory

According to Lewin’s change model, to plan change, one must analyze forces and shift the balance in the direction of change through a three-step process: unfreezing, moving, and refreezing (Sullivan, 2017). The unfreezing stage is where the need for change is identified and the plan for change is created. Bringing a group of key stakeholders together with the evidence needed to prove change is necessary is the first step needed to initiate the change. Once the key stakeholders understand the evidence presented and the need for change, in this case moving the change of shift report to the bedside and involve the patient and family to improve satisfaction, the plan for change can be created and the moving phase will begin.

The moving phase is an extremely important part of this change model due to this being the time when the individuals affected will receive the education needed for the impending change. The individuals affect may push back against the change and it is up to the leadership team to continue to drive forward with the need for change in order to reach the next phase of refreezing. Education and communication are key to ensure the team is in agreement with the change of moving the report to the bedside and including the patient and family.    

The nursing team will be given a period to implement the new bedside reporting process involving patient and family allowing for changes to be made if needed. Once the new practice has become the norm, the refreezing phase can begin as the bedside shift report standard work is added to the policy. Leadership presence should be visible during the moving phase to ensure the team is practicing according to the standard work and held accountable for reoccurring noncompliance.

Financial Implications

With the implementation of bedside shift report, the hospital could end up saving money with very little cost to initiate the change. The implementation will require educational session held at different times throughout the day to ensure all impacted staff receives the education. The hours spent by nurse educators and leadership researching evidence, training staff and gathering data would cost the hospital the teams wages during the implementation. Allowing the staff to attend the sessions while working their shift will decrease the cost by eliminating wages as the staff will not be required to come in on their days off. Once the change has been engrained into the daily nursing practice there would be no further cost to the hospital. By increasing the communication with the patients and families and involving them in the plan of care, the hospital could see a positive financial impact by increased HCAHPS which in turn would lead to increase reimbursement by CMS. WGU UOT TASK 1 Organizational Leadership And Interprofessional Team Development

Methods

To ensure the new bedside reporting process is being used and is effective there needs to be evaluations conducted. The method I chose to use to evaluate the effectiveness would be through observations and audits. Leadership presence will be required during shift change to ensure staff is continuing the change to bedside shift change report. With having the leadership present, they can conduct audits of compliance and provide live time feedback those who could improve in the process.

Rounding on patients and families by leadership should also be conducted to evaluate whether the patients and families feel included in the bedside shift report process. Each unit’s leadership team should also review the monthly patient satisfaction surveys to ensure patients and families are satisfied with their involvement in the bedside shift reporting process. As a result of the patient and family rounding and survey results, leadership will be able to investigate the staff involved in the instances of suspected noncompliance and provide feedback and coaching.

Multidisciplinary Team

Team Member Role on the Team
Team Leader The team leader would own the project and be responsible for bringing all the key stakeholders together, organizing all meetings and keeping everyone up to date. They would guide the team and help develop the new process of bedside shift report.
Unit Manager The unit manager is needed on the team to ensure the change is carried out and then followed through. The unit manager would be responsible for ensuring all staff on their unit receive the education, conduct audits after implementation and provide feedback/coaching with any staff that is noncompliant. WGU UOT TASK 1 ORGANIZATIONAL LEADERSHIP AND INTERPROFESSIONAL TEAM DEVELOPMENT
Nurse Educator The nurse educator is an integral part of this team as the educators are responsible for delivering education to the affected staff. The educator should make the information easy to absorb and implement. The educator will work with the team to develop any tools such as handouts to provide to the staff, patients, and families as ways to communicate the change in process and the expectations set forth.
Bedside Nursing Staff To ensure the success of this change, involving the bedside nursing staff is crucial. The bedside staff will be able to give valuable insight into their existing daily routine and provide helpful information on the best way to implement the new process. Involving the bedside nurse will also help gain the buy-in from all other staff affected as well.
Patient/Family Having the patient and family on the team will allow the outsiders insight as to what information they would like to be shared during shift report. The patient and family are able to take part in the development of the education for both the staff, the patient and the family. During the development and implementation of the new change, the patient and family would also be able to learn what is discussed during shift report. It is important that the education for patient and family include the patient having the right to not have family present during the shift report process. WGU UOT TASK 1 Organizational Leadership And Interprofessional Team Development

 

Team Diversity

We are all human and as such we share many commonalities but as with anything no two people are exactly alike. To ensure the success of the change to this nursing process and implementation of bedside report, it is important to have a diverse group of people on the team. Not only should the team include members from different units and disciplines, but it should also include those from age groups and different cultural backgrounds. Having the more seasoned nurse will bring their years of experience on the job to the group as the younger nurses will bring their expertise with technology. Building a culturally diverse group could help uncover issue during the development phase that may contribute to failures during the implementation phase. By establishing cultural diversity within this team leads to building a framework throughout the hospital and support the patient and family-centered care.

Leadership Theories

The leadership theory I would utilize during the implementation of the bedside shift report is transformational leadership. According to Sullivan (2017), transformational leadership emphasizes the importance of interpersonal relationships and effecting revolutionary change in organizations. Transformational leadership can positively affect the environment in a hospital and can be used by nurses during interactions with their peers and patients (Sullivan, 2017). The unit managers and other team members may find it beneficial to use transformation leadership to help inspire, encourage, and motivate the bedside nurses to embrace the change to bedside shift report and the bigger impact of involving the patient and family in the process. For this change to be successful and sustainable, buy-in from all staff affected is an absolute must. By allowing those affected to be a part of the change will also inspire them to look beyond themselves and their needs to then focus on what is best for the patients and their families. WGU UOT TASK 1 ORGANIZATIONAL LEADERSHIP AND INTERPROFESSIONAL TEAM DEVELOPMENT

Implementation of Strategy

With the focus of patient- and family-centered care becoming at top priority for the hospital, the change to bedside shift report and including the patient and family will need to be made as soon as possible. After the team has developed the standard work that will be followed, the nurse educator and unit manager from the team will present the standard work to all other nurse educators and unit managers throughout the hospital. Once the team determines a start date for the new process, the educators and managers will be responsible for educating the nurses on their respective units. Standard work education can be completed through attending educational in-services and then utilizing see one, do one, teach one technique. These methods allow the bedside staff to be educated while working their shifts.

Using the see one, do one, teach one method, as one nurse is educated and uses the standard work, they can then educate another nurse. Each nurse will be provided with a copy of the standard work to refer to until the new process becomes their normal everyday practice. A handout created to explain what the bedside shift report is and what patients and families should expect will be provided to each new patient upon admission to the hospital. The audit form that will be used to track compliance will be made available to the bedside staff as well.

The expectation set by the team will be that an 80% compliance rate will be achieved within the first month and a 100% compliance by the third month after implementation. The bedside nursing staff must be held responsible that conducting bedside report is the new process, held accountable by their peers and re-educated when necessary. The end goal of the process change is for patients and families to feel more involved and have more input in the patient’s plan of care.

Communication to Organization

The success of this new nursing process change relies heavily on the communication present to the staff. Being open, honest, and transparent will be the key to the bedside staff embracing the change. The communication regarding the change to bedside reporting should start as soon as the project team is formed. The unit managers should begin discussing the impending change at their monthly unit meetings. Early communication with the bedside staff will allow for questioning the need for change as well as the chance for education based on what is found using the PFCC.

When it comes time to start the education, emails will be sent to all staff needing to receive the education as well as flyers posted throughout the units in the hospital. The standard work will be made available to the staff as soon as education begins. Just prior to the determined start date, the patients and families will begin to receive the bedside report handout upon admission to the hospital. WGU UOT TASK 1 Organizational Leadership And Interprofessional Team Development

Communication to the unit managers regarding the expectations from an auditing standpoint is also important. Auditing the bedside staff to ensure the process change is implemented correctly and sustained is as important as the implementation itself. The bedside staff should also receive the communication regarding the audits that will be conducted and compliance with bedside shift report is an expectation and compliance will be audited. The staff should also be aware of coaching and further disciplinary action could be taken for any repeated noncompliance. The bedside staff should also have the ability to communicate and concerns they have regarding the bedside shift report process after implementation. Continued open communication between staff and leadership must continue after implementation to ensure bedside shift report including patient and families is successful and sustainable. WGU UOT TASK 1 ORGANIZATIONAL LEADERSHIP AND INTERPROFESSIONAL TEAM DEVELOPMENT

Tools for the Team

With the use of the Keirsey Temperament Sorter, the project team will be able to assess the best way each person can benefit the team. The Keirsey tool identifies 4 different types of temperaments through a series of questions: Artisans, Guardians, Idealists, and Rationalists. Each personality is important to the team and by using the assessment, the strengths and weaknesses of the team members will be identified. This will allow the members to gain an understanding of their own temperament as well as the temperament of the other team members. This tool will help the team know which members are better suited for certain tasks and who can work well together within the group. Through the encouragement of self-assessment, each member of the team will be able to obtain the perspective necessary to work towards the changes desired by the organization.

WGU UOT TASK 1 ORGANIZATIONAL LEADERSHIP AND INTERPROFESSIONAL TEAM DEVELOPMENT References

CaroMont Health. (2019). About Us. Retrieved from:

https://www.caromonthealth.org/About-Us.aspx

CMS.gov. Centers for Medicare and Medicaid Services. (2017). HCAHPS: Patients’

Perspectives of Care Survey. Retrieved from: https://www.cms.gov/Medicare/Quality-Initiatives-patient-assessment-instruments/hospitalqualityinits/hospitalhcahps.html

Keirsey. (n.d.). The Four Temperaments. Retrieved from:

https://keirsey.com/temperament-overview/

Roussel, L, A., Harris, J. L., Thomas, T. (2016). Management and Leadership for Nurse

Administrators, 7th edition. Retrieved from: https://wgu.vitalsource.com/#/books/9781284104677/cfi/6/2!/4/2/2/2@0:0.0993

Sullivan, E. (2017). Effective Leadership and Management in Nursing, 9th edition. Retrieved

from: https://wgu.vitalsource.com/#/books/9780134153209/cfi/6/2!/4/2@0:0

United States Census Bureau. (2018). QuickFacts. Gaston County, NC. Retrieved from: WGU UOT TASK 1 Organizational Leadership And Interprofessional Team Development

             https://www.census.gov/quickfacts/fact/table/gastoncountynorthcarolina,US/PST120218

WGU UOT TASK 1 ORGANIZATIONAL LEADERSHIP AND INTERPROFESSIONAL TEAM DEVELOPMENT