Managing Change in Healthcare - Assignment Example

? Nursing Management Nursing Management Define organizational climate and relate its impact on performance. Hall (2005) argues that an organization’s climate include the general dimensions of the organization’s environment such as role, leadership, communication, ethics and safety. An organizational climate is superficial to any organization as the climate is linked with motivation and behavior, which reside at the organization level. Hall notes that the organizational climate is relatively temporary with respect to direct control. It is restricted to certain aspects of the organization as perceived by members of the business (2005). Thus, it is the perception of members in relation to the features of an organization like decision-making, leadership, and ethics at work. Hall (2005) notes that an organizational has a lot of impact on nurses’ achievements. For instance, there is evidence is links the organizational climate to the behavior, motivation and attitudes of clinicians. The orientations and behaviors can in turn affect the quality process and clinical outcome with regard to performance. Stone et al. (2010) note that studies within and outside the healthcare sector reveal that employees experience greater job satisfaction, and less stress, and burden when working under organizational climates that have empowering and supportive leaders, and structured organizational arrangements, and positive groups. In addition, employees’ satisfaction and commitments to their work have been found to reduce turnover and absenteeism. These findings have valuable implications for clinicians and healthcare centre managements. For instance, stable health care environments that empower and support nurses are more likely to boost nursing staff satisfaction and commitment. In turn, a more satisfied nursing staff will be ready and more willing to contribute to patient satisfaction, assist in error reduction, and assist in the implementation of other measures geared toward the improvement of health care quality. 2. Older nurses on a unit continually refer to younger nurses and students as being less committed to patients than their generation of nurses. This is causing a gulf between older and younger nurses, as well as a morale problem. Based on Toffler's description of the reasons for generational differences, propose an approach for stabilizing the conflict. Generational differences at the workplace are one aspect that causes a lot of concern between the young and the old. However, Toffler argues that all generations irrespective of age, have similar values, it is only that they express these in different ways. As such, there is no need for these differences since both the old and the young have responsibilities to play at the workplace. Toffler proposes a number of ways by which the two different generations can stabilize and eliminate the conflicts between them. Firstly, he argues that everyone irrespective of age wants respect. Therefore, it is important that the two generations respect one another as this will help stop antagonism between them (Deal and Center for Creative Leadership, 2007). Secondly, the two generations should develop mutual trust between each another without one side despising the other. Both the old and young nurses should trust one another at the work place irrespective of the level of experience that one has. This will help mitigate the conflict between the two groups. Deal and Center for Creative Leadership (2007) note that intergenerational conflicts are exaggerated by organizational politics. It is, therefore, important that the nurses, old or young, refrain from engaging in divisive politics as this only increases the rift between the two generations. This will see a reduction in conflicts between nurses from the two divergent generations. 3. During a floor meeting, the head nurse on a unit explains to the staff that evaluations are going to be late because she had to take a fill in for the unit secretary, who was on vacation for a week, and then had to take a full-patient assignment because of staff vacations and nurses who called in sick. She seems to take the situation in stride even though expected salary increases and evaluation interviews will be delayed. What principles of management are being violated? As a staff nurse whose salary increase will be delayed, respond to her announcement. Kreitner (2007) argues that every human being has many needs and desires. However, no single individual can satisfy all his needs. It is for this reason that people work as a team to meet their mutual needs that they cannot accomplish individually. At the work place, formal groups can achieve their missions effectively only when people working in the group are coordinated and controlled in a proper manner. This raises the issue of management that involves the coordination of others’ efforts to get positive results. The case entails management in which the head nurse had to take a fill in for the unit secretary. However, it is evident that certain management principles identified by Henry Fayol are being violated. One principle being violated by the head nurse is subordination of individual interests to the general interest. Fayal argued that the interests of a single individual should not supersede the interests of the whole organization. In the case, it is apparent that the head nurse violated this principle as her action will lead to the delay of evaluation interviews for all staff members. This in turn leads to salary delays that could otherwise be avoided with appropriate action. Such an act, Fayol argued, should not be allowed within an organization. The head nurse’s action also violates the staff nurses’ remuneration principle, as members should be able to receive their salaries in time to enable them, just like the organization, meet their obligations (Kreitner, 2007). 4. Should nurse-staffing ratios be mandated by legislation? Nurse staffing ratio refers to the number of patients that a given nurse handles at any given time. Adequate nurse staffing is key to nurse retention and patients care. This is mainly because understaffing usually endangers the lives of patients; results in longer stays in hospitals; and results in high staff turnover rates, which is expensive. The staffing ratios have been a major concern in the health care profession and care facilities. In most cases, the hospital managements tend to under staff their facilities by employing a few nurses to handle a very large number of patients in the name of cutting down costs. This in most cases leads to job dissatisfaction by nurses which in turn endangers the lives of many patients (Hammaker and Tomlinson, 2010). Despite the various arguments put forward with regard to nurse staffing ratio, it is obvious that there is need for a definitive minimum staffing ratio in order to provide a safe and effective patient care. However, this may not be possible if everything is left at the hands of hospital management to determine the ratio of nurse-to-patient. This is so because most of them are profit making and as such will do everything to cut down costs such as by employing a few nurses to take care of patients. For this reason, nurse-to-patient staffing ratios need to be enforced. Legislations which will determine the number of patient that a given nurse should take care of should be instituted therefore. Any hospital that violates such a law should be punished or deregistered as it puts the lives of many people to danger. This will ensure that every hospital has adequate staff to handle patients thus increasing quality of medical healthcare. This will also see a reduction in mortality rates across all the hospitals (Hammaker and Tomlinson, 2010). 5. Health care is synonymous with change. Yet, often we feel as though change cannot happen within our own environment. Explore this dynamic. Parkin (2009) argues that change is value-neutral and is a vital condition for an organization’s survival. For this reason, every organization and individual should never end the search for improvement in order to gain competitive advantage. Handy once noted that maintaining the status quo under the current climate is a bad option (Parkin, 2009). This change is also synonymous in the health care facilities. Change is usually witnessed in different levels. The first level entails improvement of departments’ effectiveness while the second level is where change is introduced to the organization’s sub-systems. The third level involves the organization’s large shift in values and ways of providing services. The implementation change within the health care facilities has not been that rosy. This is mainly because managers and individuals see it as a threat and always tend to resist it. Parkin (2009) notes that workers tend to feel safe, confident, and comfortable in their habitual roles which they have natured over time. He argues that implementing change threatens the comfort within health care workers bringing loss of absolutes that previously characterized less uncertain times. When roles within health care are subjected to change, loss of valued structures, symbols, and relationships that may have previously served as clear delineation of an individual’s responsibility may result. This makes managers and workers resist change. Politics of power also usually play out any time an organization is attempting to change. Coghlan argued that any form of research in an organization has the dynamics of politics and that these political forces tend to undermine change efforts. When a health care is in the process of changing, where balance of power is modified, political forces do come into play to thwart the change efforts. This involves the subversion of the organization’s plans, denying access to data or personnel, or fights for removal of personnel championing the change. This is mainly because they see the change as a threat to their survival and dealings (Parkin, 2009). 6. How does your institution plan for nurse staffing? Paetznick (1966) notes that nursing care of patients in hospitals depends very much on the number and quality of nursing personnel that are on duty at any given time of the day or night. Recognition of problems regarding staffing and the planning of their solution within our hospital usually begin with the Director of Nursing Servicers. Using a guide as a tool for discussion, he/she first enlists the support of the hospitals administrator and the hospitals physicians in charge of the various clinical services. He then discusses the guide with his assistants, head of nurses and supervisors to whom some work have been delegated with regard to planning and supervising of patient care. Paetznick (1966) suggest that the general discussion with the various groups on improvement of patient care via ward staffing usually reveal certain problems. These included: a) Time and work assignment improvements; b) Training of auxiliary nurses; c) Improvement techniques with regard to nursing care of patients; d) The urgency to employ more nurses; e) Evaluation of individual performance of nurses; f) Optimum use of staff through supervision; and analysis of work performed by different groups of workers. After the conference, several members of the supervisory staff are asked to make written reports of the discussion, go through the guide, and make recommendations regarding its use. This initial stage of the study of staffing problems involves members drawn from supervisory nursing staff that are particularly interested and are responsible. Paetznick (1966) notes that it is important for the Director of Nursing Services to direct and interpret the study himself or delegate the work to any competent member of the staff. In case a shortage of staff is identified, the vacancy is advertised through print media and website for interested applicants to apply. Interviews are then carried out and the vacancy filled. 7. Nurses must be good stewards of resources, which means being accountable for judicious use of resources. How can you create an environment to support this accountability? Resource management is critical to any organization since any waste may translate to a cost. Nurses needs to be stewards of the health care resources and be should be accountable for everything that they do with the resources under their disposal. This issue is a major concern to many health care facilities that incur a lot of cost due to poor management of the health care resources by nurses. Swansburg and Swansburg (1995) suggest that it is important that the management of the health care facilities create an environment that supports accountability. One way of doing this is by instituting a strong internal control system within the internal auditing department that would ensure that all members of the staff become accountable to all the resources that they use. The fact that nurses will be aware that there is someone at the audit department capable of trailing the movement of the institution’s resources, will make them become more vigilant and accountable. In case a discrepancy is noted, this should be discussed in depth and if possible, any nurse found wasting healthcare resources deliberately or cannot account for resources under their disposal should be punished (Swansburg and Swansburg, 1995). Another way by which a hospital can create such an environment is through education. The hospital’s management should be able institute an education forum with all the nurses and other staff members to educate them on the importance of being good stewards of hospital’s facilities. Through education forums, nurses will learn and in turn begin to avoid instances of mischief and dishonesty or waste. This will result in accountability by all nurses and members of hospital’s staff (Swansburg and Swansburg, 1995). Reference Deal, J., & Center for Creative Leadership (2007). Retiring the Generation Gap: How Employees Young And Old Can Find Common Ground. San Francisco: John Wiley & Sons. Hammaker, D., & Tomlinson, S. (2010). Health Care Management and the Law: Principles and Applications. New York: Cengage Learning. Kreitner (2007). Management: Tenth Edition. New York: Cengage Learning. Paetznick, M. (1966). A guide for staffing a hospital nursing service: World Health Organization Geneva. Park Ridge. Parkin, P. (2009). Managing change in healthcare: Using Action Research. London: SAGE Publications Ltd. Stone, P., Harrison, M., Feldman, P., Linzer, M., Peng, T., Roblin, D., Scoutt-Cawiezell, J., Warren, N., & Williams, E. (2010). Organizational Climate of Staff Working conditions and Safety-An Integrative Model: Advance in Patient Safety: Vol.2. Swansburg, R.C & Swansburg, L.C. (1995). Nursing staff development: a component of human resource development. Massachusetts: Jones & Bartlett Learning. Read More