Microsystems Assessment of an ICU Unit - Essay Example

Microsystems assessment of an ICU unit A clinical microsystem is defined as an assembly of people who work in unison on regular basis so that they may give health care to distinct subpopulations.it has both business and clinical aims, they share the same information within the environment, the processes carried out are interlinked and the outcome is produced from the performance. Clinical micro-organizations are the front-line divisions which give health care to numerous people. These are places where the families, care teams and the patients meet. A patient is anyone who is at the Centre of every micro organization. Microsystems can be defined as where safety, efficient, reliable, quality, and innovate care is made. Patient satisfaction and staff morale are made here. They micro system also includes recurring design of information, support staff, technology, behavior, process and results. Patient is very significant in each clinical micro system. LEVEL I. Inpatient Care Unit Profile The team that forms the microsystem is supposed to do assessment, diagnosis and treatment to their microsystem just like clinicians do. The major step which is used to treat a micro system is treating it and in order to achieve higher performance the team should assess their practice. This will involve learning about the 5Ps which are patients, pattern, professionals, purpose and professionals (Kenney, 2008). The assessment 5Ps should be conducted by an interdisciplinary team. Assessment and reflection of interdependence and connections of the 5Ps normally reveals redesign opportunities and new improvements of the microsystem. The 5Ps are discussed as follows; Purpose Purpose should be assessed first. The team should consider the reasons for the existence of inpatient Unit. The main purpose of in-patient care unit is the provision of achievable care for the patients. Though each micro system might be having its own mission statement, its purpose may be too far beyond the simplest meaning of the statement so that it can reflect values, beliefs, culture, aspirations and attitudes all those people who compose the microsystem unit. However, this commitment and energy is rarely explored. The entire group that makes it is supposed to take time and discuss a care process which will enable the business to explore the energy and assurance. A discussion of the 5Ps reveals the view of each member about the microsystem and its purpose, illustrating commitment and describing a better way for setting purpose priority and making of decisions. Professionals Professional is any person of the microsystem who contributes and provides care. Each member who is playing a role in the organization is respected and having that fact to be evident arouses self-esteem, engagement and morale during care process. It does not matter the type of task which each individual is assigned but should be done with dignity and well because it contributes greatly to the functioning of everything surrounding it and all people are supposed to value it accordingly. All the professional in an organization should be identified by understanding the number of hours they are working, their core duties, what they need to learn and want to know, what they are aspiring towards contribution to the future improvements of the firm and levels of awareness of satisfaction and directions for personal development. Patients Each individual member of the organization should be having full knowledge of the patients they care about. Examining of the patients deeply helps in understanding the patient’s subpopulations and their populations which can be a treasured insight which can be used to improve the design of the care and decision making. It also improves the services and enhances continues improvement of the care which is given to the patient population. Process There are numerous processes and steps which are involved in care of the patients in the organization. There are some tasks which are sequential, overlapping, interrelated and/ or complementary. Difference in assumptions, perceptions and views are distinctive though hidden, but they are exposed by the objective and need to develop a flowchart of high-level of the care process or the experience of the patient since the time of their admission to the time they are discharged. The lack of knowledge concerning the process leads to reduction of reliability of care and creation of waste of care production of the organization, yet it increases the risks. The use of flowcharts helps in uncovering information of the current position of the process and becomes the basis for planning for a more effective and efficient care systems. One should also consider gaining insight to customers or patients experience for health care process in regards to the professionals practice (Joint Commission Resources, Inc., 2011). Patterns Pattern is found in every microsystem but it is often ignored or overlooked. It is imperative to be active in analyzing and identifying patterns. Professional is not supposed to forget to occasionally identify achievements of the professionals who are within the organization. This nurtures the purpose and value team work and collaborations of patients. LEVEL II. Microsystem Assessment: Care Environment Leadership The major role of a leader is to achieve set goals and empower personal accountability and autonomy by building actions which are respectful and reflecting. They are supposed to nurture a culture which is positive (Nelson, 2011). Organization support A larger organization is better because it provides information, resources and recognition that will improve the work performed by the microfinance and be easier to meet patient’s needs. Staff Focus The microsystems should hire people who are right for certain positions. Professionals should be given orientation so that new staff members are integrated to work roles and becomes conversant with the culture of the microsystems. Education/training Patient care and education are incorporated into the flow of expected benefits from available resources. It is responsibility of a microsystem to train and educate its staff which counts a lot for the success of the organization. Interdependency Microsystem staff is mainly characterized by collaboration, respect, trust, willingness in helping each other, recognition and appreciation of the significance of complementary roles. Patient care is offered by a team which can recognize all the contribution each other staff has made to shared purpose. Community and Market Focus The microsystems usually employ resources to assist them in working with the community. The microsystem is supposed to establish a relationship with the community which is innovative and excellent (Batalden, Nelson & Godfrey,2007). Performance Results Performance of the organization is focused on costs which are avoidable, competition, use of data feedback, encouraging competition which is positive and having open discussions about the performance of the microsystems. Process Improvement An environment for redesign and learning is reinforced by monitoring of care which is continuous and use of frequent tests change. There are numerous resources which support improvement of the microsystem operation. Information Technology Information in the care environment of a microsystem is referred as a connector. It facilitates efficient and effective communication and multiple informal and formal networks which keep each person all the time informed. Patients have many ways through which they can get the information they want. Technology enables a smooth connection between patient care and the information by giving effective, timely access to reach the environment for information. The environment for information should be designed in support of the work of the microsystems. LEVEL III. Evaluate Resources The internal situation which makes a microsystem to improve the health of certain subpopulation of patients is that they like advancing their services and meeting all their valued patients’ needs. A micro system employs numerous tools and methods to develop the unit which will by the staff and leaders in assessing them. They aim on increasing on the capacity of the microsystem on recognizing its potential and so that they may relate or compare their services with other microsystems which are in the same service continuum. All the data which has been collected from the microsystem assessment is reviewed by an interdisciplinary team. It is not only the information of the assessment tools which is reviewed but the team is supposed to synthesize all the metrics that matter and assessments so that they may obtain the main objective of the microsystems (Joint Commission Resources, Inc., 2011). They should also identify any data linkages and information by considering; mismatches among the patients population wants and the professionals who are assembled to provide the patient services and care. In the case of new services, there is always need to design a care. Evaluation of material and human resource management in a microsystem is of great value to both the patient and the organization itself. It helps in developing areas which have not been performing well or which has not given the right service to the patients. LEVEL IV. Patient Care Planning/Coordination/Outcomes The American Nurses Association’s Code of Ethics and the Clinical Nurse leader institute the need for direct clinical leadership during care. The operations are performed through a safe delivery, based on facts and aim to achieve best quality results for the cohort of patients they serve. The preparation of the Clinical Nurse Leader follows the guidelines of safety and improves safety care for patients. The Clinical Nurse Leader links the administration to the quality of delivery to provide efficiency and security of the patient (Joint Commission Resources, 2011). The Chronic Care Models allows patients with chronic diseases to receive a variation of health care from health organizations. The program is nationwide and extends to cover poor populations to improve the health of those suffering from chronic illness. To maximize the outcomes, the cost of the unit resource is increased by one. The increase in unit resource will create extra results (Joint Commission Resources, 2011). Using evidence-based guidelines and medication, health care will include policy that involves the establishment of clinical evidence based outcomes in relation to association of practice. Evidence-based guidelines improve the quality of health care standards and minimize the cost of care. Electronic health records and new methods of distributing wages will serve to implement technology in operations and improve the quality of health care (Joint Commission Resources, 2011). The Standard Occupational Classification teaches people to participate in contributing to individual health. They gather information, make arrangements for planning, implement, supervise and deduce programs that aim to improve health living. Health education fosters monetary and human costs that people and the community spend on health care. This occurs by focusing on preventive measures. Social science is a method used to educate people about health. Videos and brochures are also used to teach health education (Joint Commission Resources, 2011). Lateral integration of care is a process to promote interdisciplinary communication and coordination in health care among patients to ensure quality of health care is not compromised because of stop-gap professionals. The Clinical Nurse Leader applies this process to assist families and patients maintain quality health care system. It improves the recovery chances of the patient through maximizing safety (Joint Commission Resources, 2011). Level V: Measurement and monitoring In performing a worksite analysis, management seeks to reduce the potential risks that can affect the employees. The trend analysis should be comprehensive and effective. The Job Hazard Analysis includes an inspection of operations. The process proves effective because it ensure safety is maintained. Errors in recording information can produce inaccurate results. The process can be inconsistent creating a change of factors that determine the feasibility of the study (Miller & Steiner, 2014). A sentinel event is an unforeseen death or severe injury and requires instant examination and retort. The victim could lose a limb or the event could reoccur creating more harm to the population and community. Majority of sentinel events originate from an error. Insufficient communication between health care practitioners is the major cause of sentinels. Root-cause analysis is enforced by the Joint Commission stipulating the need for inquire 45 days after a sentinel event focusing on processes and systems (Miller & Steiner, 2014). Readmissions rates describe the interval of 7, 15 or 30 days prior to admission that can occur in the same hospital after discharge. Language barriers are associated with readmission rates. Statistics reveal African Americans as the highest and Latin Americans as the lowest when considering rates of readmission. The presence of cultural interpreter assists reduces the challenge (Miller & Steiner, 2014). Nurse sensitive indicators describe the system and procedure and results of nursing care. The aspect of evaluation, intervention and RN job satisfaction are part of the process indicate. Nursing sensitive indicators determine the results of patients. Measurement issues provide a challenge the process evaluation to determine the development of the process (Miller & Steiner, 2014). Risk reduction data is strategy to collect information for re-diagnosis of patients and results to avoid risk of unforeseen risks that can affect the health of a patient. The limit in number of equipment is a significant challenge because complex equipment is required to perform in-depth analysis of the condition and factors affecting the patient (Miller & Steiner, 2014). LEVEL VI. Conclusion For a micro system to improve its outcomes it need to change the allocation of resources. A reallocation of funds or resources may improve on the outcomes for instance, offering transportation to the staff will help them attend more patients and it will also help them to report to work on time. Program structure should be changed if the performance outcomes decrease. A retrospective study should be done if a problem is identified. A solution should be done by use of inexpensive and excellent method for exploring the solutions and causes of the problems. APPENDIX A1 A2 L1 Reference Miller, R. D., & Steiner, J. (2014). Problems in health care law: Challenges for the 21st century. Burlington, MA: Jones & Bartlett Learning. Batalden P., Nelson E., & Godfrey, M. (2007). Quality by Design: A Clinical Microsystems Approach, San Francisco, CA: Jossey-Bass. Bodenheimer, T. & Grumbach, K. (2007).Improving Primary Care: Strategies and Tools for a Better Practice. USA: McGraw-Hill Publishers. Kenney, C. (2008).The Best Practice: How the New Quality Movement is Transforming Medicine. NY: PublicAffairs. Joint Commission Resources, Inc. (2011). The medical staff handbook: A guide to Joint Commission standards. Oakbrook Terrace, IL: Joint Commission Resources Nelson, E. (2011). Value by design: developing clinical microsystems to achieve organizational excellence. San Francisco: Jossey bass. Donaldson, M. S., & Mohr, J. K. (2000). Improvement and innovation in health care microsystems. A technical report for the Institute of Medicine Committee on the Qual-ity of Health Care in America. Princeton, NJ: Robert Wood Johnson Foundation. Kosnik, L., & Espinosa, J. (2003). Microsystems in health care: Part 7. The mi-crosystem as a platform for merging strategic planning and operations. The JointCommission Journal on Quality and Safety, 29, 452–459. Mohr, J. (2000). Forming, operating, and improving microsystems of care. Hanover:Center for the Evaluative Clinical Sciences, Dartmouth College. Read More