Discussion Responses -Discuss how nurse managers and nurse leaders contribute to the reengineering of health care.

Discuss how nurse managers and nurse leaders contribute to the reengineering of health care.

Nov 21, 2022, 2:22 PM

Reengineering is a valuable knowledge tool that nurse managers can put to use across health care settings, Nurse managers become process-owners, and as such can affect substantive positive change within their organizations (Pilon, 1997). As organizations evolve, health care leaders must evolve as well. The synergy model for patient care is one that takes the patient’s needs and matches them with the competencies of the nurse (Helbig, 2020). Nurse managers must consistently use the tools and evidenced based practice to increase and maintain efficiency, and cater to the needs of all those within their care andleadership. Often leaders must pivot and reengineer their processes with continuous changes in resources, staff, and policies. They must assess their current available resources in contrast with the needs of their unit and make changes accordingly to provide the best outcomes for all involved with the current situation they have. 

Pilon B. A. (1997). Reengineering knowledge and skills: essential for nurse managers. Seminars for nurse managers, 5(2), 70–74.

Helbig, J. (2018). Reengineering Health Care Management. lc.gcumedia.com. https://lc.gcumedia.com/nrs451vn/nursing-leadership-and-management-leading-and-serving/v2.1/#/chapter/

Discuss how nurse managers and nurse leaders contribute to the reengineering of health care.

Nov 22, 2022, 4:05 PM

Nurse managers and nurse leaders play an important role in the reengineering of health care, as they are responsible for identifying the need for change, developing plans to implement change, and evaluating the results of change initiatives. In addition, nurse managers and nurse leaders are often involved in the development and implementation of new technology, which can play a crucial role in improving the efficiency and quality of patient care. Identifying the need for change involve identifying problems with current processes or practices or identifying the opportunities to improve patient care, by working with the healthcare team to develop plans to implement change which may involve changes to processes, practices, or technology and are responsible for evaluating the result.

The nurse manager or leader can re-engineer healthcare and may take responsibility for changing the current policies, practices and procedures, a good example is the transformation many hospitals underwent due to covid-19 pandemic. It was necessary to create new procedures for observing safety and avoiding infection to resolve the situation. According to (Popejoy et al., 2020) “design to improve hospital discharges, the reengineered Discharge program (RED) prepares the hospitalized patients for discharged back to their homes” (p.158). Therefor all internal logistics for implementing these procedures become the nurse leader’s responsibility.

Nurse managers and leader’s role in reengineering healthcare is being an advocate for patients and staff as well as making sure the hospital environment is calm and functioning smoothly. Advocacy is a process used to facilitate growth in others. The nurse leader served in health policy making by helping to shape and develop policies that foster better outcome at both national and organizational level, by involving in commission and advisory committees where they serve actively to improve patient care and advance health systems (Alvarez et al., 2019). They also contribute to ethical decision-making; they get update on the legal aspect of their discipline to Safegard patients well-being and avoid litigation from malpractices

Discuss how nurse managers and nurse leaders contribute to the reengineering of health care.

Nov 22, 2022, 8:47 PM

One thing is certain in healthcare and that is change is inevitable. Things must change in health to improve the quality of care provided. Nurse leaders and managers help change healthcare by making the patients a top priority and the staff members a top priority. They can focus on all staff members providing quality care while meeting productivity and quality indicators (Helbig, 2018). Nurses can have the biggest impact on healthcare as nurses are the largest segment of the U.S. workforce as a whole (American Association of College of Nursing, 2022). Nurses are also the largest component of the healthcare workforce (American Association of College of Nursing, 2022). People can make the biggest impact when they come together to achieve the same goals and outcomes. Nurse leaders can impact change in healthcare by focusing on the outcomes of delivery provided, recognizing the importance of implementing evidence-based practice, and reevaluating their effectiveness in relation to patient outcomes and safety (Helbig, 2018). The goal is to improve quality and outcomes, improve an organization’s culture, and reshape care delivery by working together (Thew, 2018). Nurse leaders can change and improve healthcare by standing together, standing up, and advocating for themselves and their patients.  

 American Association of College of Nursing, Sept. 2022. Nursing fact sheet.https://www.aacnnursing.org/news-Information/fact-sheets/nursing-fact-sheet 

Helbig, J. (2018). Nursing leadership & management: Leading and serving.  https://lc.gcumedia.com/nrs451vn/nursing-leadership-and-management-leading-and-serving/v1.1/ CH. 5

Continuous quality improvement (CQI) is the responsibility of all nurses and is vital when addressing the challenges of the health care industry. Provide an example of how you would apply CQI in your current or past position.

Nov 22, 2022

Continuous quality improvement is important to healthcare progress. Healthcare has quality improvement initiatives to improve outcomes for patients, families, and healthcare workers. According to Health Catalyst Editors, (2022), quality improvement initiatives can focus on clinical, financial, and operational, and can have a significant impact on total cost of care, clinical outcomes, care variation, decision support, length of stay and so much more (para 2.). The goal in quality improvement is to identify areas of improvement, collect data, analysis the data, set measurable goals, communicate the results, and ongoing evaluation of quality indicators, and clinical outcomes (Helbig, 2018).  

I currently work for a company that completes chart reviews on every chart. The chart reviews are completed by our peers and feedback is provided. If the patient care is concerning the case is escalated to the medical director and educator. The team is then brought together to evaluate the case and improve the process of patient care, protocols, or processes. I would like to see more case reviews in the ICU. Case reviews can provide education and identify areas for improvement in nursing care processes. The data can be collected on patient outcomes in similar situations after the case review has been completed. The goals can be determined based on each scenario. For example, getting patients to cat scans in a timely manner. Sharing goals and the results weekly or as needed can help promote communication. I think continued education about real-life situations will allow further growth in all aspects of healthcare.

Continuous quality improvement (CQI) is the responsibility of all nurses and is vital when addressing the challenges of the health care industry. Provide an example of how you would apply CQI in your current or past position.

Nov 22, 2022

Continuous Quality Improvement (CQI) involves gradually improving processes, safety, and patient experience. CQI may aim to improve operations, results, system processes, the workplace environment, or regulatory requirements. Process improvement can be “gradual” or “breakthrough.” CQI project development typically begins with defining the problem, followed by benchmarking, goal setting, and incremental quality improvement projects (O’Donnell & Gupta, 2022). Improvements are implemented using the iterative process, the impact of the adjustments is measured, and the process is repeated until the ideal outcome is reached. Lean, Six Sigma, Plan-Do-Study-Act (PDSA) cycles, and the Baldrige Criteria are common improvement methodologies I can adopt to improve healthcare quality in my current position. 

I can adapt CQI to improve healthcare-related communication regarding individual patients during shift changes of nurses and other healthcare professionals. About 80 percent of medical errors can be associated with poor communication among healthcare providers, especially during shift changes (Washington University, 2017). For instance, medical errors at the healthcare facility had happened when a critical diagnostic test was not communicated clearly, specifically from one clinician to the next at the shift change. Improving communication at the shift change would help minimize the majority of medical errors and improve patient safety. A thorough three-hour training program focused on enhancing oral and written communications would significantly elevate patient safety without burdening the current workflow. The training program will include role-playing, computer training, structured shift change communication using mnemonics, and interaction with electronic health record information and how to share it with other providers.

References

O’Donnell, B., & Gupta, V. (2022). Continuous quality improvement. In StatPearls [Internet]. StatPearls Publishing.

Washington University. (2017, November 5). Medical errors drop with improved communication during hospital shift changes. https://source.wustl.edu/2014/11/medical-errors-drop-with-improved-communication-during-hospital-shift-changes/

Continuous quality improvement (CQI) is the responsibility of all nurses and is vital when addressing the challenges of the health care industry. Provide an example of how you would apply CQI in your current or past position.

Nov 21, 2022 

I work in home health. Centers for Medicare and Medicaid require that we meet specific benchmarks in quality, safety, and patient outcomes. This is reported to CMS through a special assessment performed at admission, recertification (every nine weeks), discharge, and resumptions of care after a hospitalization. The assessment is called an Outcome and Assessment Information Set or OASIS. The home health agency is ‘graded’ on how well they perform. The OASIS can be used by management to pinpoint when a particular care item is not being executed adequately. These are chosen for key improvement indicator (KPI) projects. We have televisions for each department that posts the monthly KPI.

An example would be as follows: The nursing staff will fill out medication side effect forms for each admission and have them signed by the patient 100% of the time. There will be an evaluation of the KPI item as well, which would be as follows: The clinical manager will contact each admission within one week of the start of care and verify that the patient understands the side effects of their medication. The value on the CMS report is then monitored for improvement. Our department has successfully used this KPI method to improve overall scores from 85 to 99.

The OASIS changes from year to year. This January, we will be using OASIS-E. I participated in an online training seminar that lasted two days to become more proficient in my knowledge of the OASIS-E and assist the nurses in my department with charting questions.