Improving Patient Care Model For Inpatient Units At Moffick Hospital - Research Proposal Example

 Improving Patient Care Model For Inpatient Units At Moffick Hospital 1. 1. Organizational Context: overview of the organization's location, size, structure, and activities Moffick Hospital is an academic medical facility that is recognized nationally. Founded in year 1956, the 500 bed capacity hospital is one of the biggest in downtown Chicago. This hospital was founded a decade after the historic world wars in the aim of treating soldiers who developed complications subsequent to the injuries they sustained during the wars. The name Moffick was inherited from a medical student who raised the plight of warriors and suggested an independent hospital for them. Since its establishment, the hospital has been majoring in reconstructive therapy and surgeries. The oncology department was established following its expansion in the year 2000. The facility attracts international patients due to its well qualified and specialist surgeons and clinicians. The hospital has Inpatient Department, which includes an Intensive Care Unit, Oncology/Medical Surgical Unit, and Telemetry Unit. The staff capacity includes 30 permanent specialty surgeons, 30 semi-permanent specialty surgeons, 150 clinicians and 155 nurses. Various unfavorable situations within the operations of the hospital contributed to poor patient satisfaction. Moffick Hospital being an academic institution, a research facility as well as a specialist hospital provision of quality health care needs to be prioritized. Currently, the reputation of the hospital seems to be more unpleasant contrary to its previous glory. In order to regain best reputation in the region, Moffick Hospital management looks forward to ensuring delivery of quality service in addition to patient safety. In order to boost patient satisfaction, the hospital intends to reduce the duration that patients wait to be treated. With the new mission and vision statements; it will be the responsibility of personnel in top level management of departments, the medical staff of the hospital and all the employees to work collectively to ensure the patients get better services (McLaughlin et al 2012). The change initiative at Moffick Hospital under new mission and vision statements follows the model of excellence in leadership. The core areas identified include integrity and teamwork. The framework established aims to be results oriented with focus on engaging stakeholders, managing challenges of change and growth from the experience of the past and those of well experience employees. 2. Your Leadership Role and Vision: your title and function within the organization and your personal leadership vision for change As the Chief of Executive Operations of Moffick Hospital since April 2014; the roles bestowed to me by the Board of Governors for this position are wide, and I intend to match them for the benefit of our patients. My first and foremost role is to communicate the vision and mission statement of Moffick Hospital. The vision statement-as known to many-states, “our tradition is to treat patients with dignity, excellence and compassion”. The mission statement states “to be worlds renowned specialty hospital” strategic leadership is the second duty that my office needs to exhibit. In collaboration with the Board of Governors, persons in top level management of departments, the medical staff of the hospital, all the employees and the community, I unveil the new vision and mission statements. 2. The vision statement states “to provide exceptional and compassionate service to our loved ones”. On the other hand, the mission statement states “The Moffick Hospital provides evidence-based patient care by embracing technology and new knowledge for the local and international patients." In strategic leadership, I have conducted surveys that aided in coming up with a more collaborative approach to patient care which may improve overall patient satisfaction and sustenance of the same. There are many other roles, but those mentioned are enough for the moment. The initiative change model proposed here encourages the CEO to become a strategic leader as well as the adaptive leader. The employees of Moffick Hospital come from various backgrounds and cultures. Also, the hospital having a capacity to accommodate international patients tends to receive patients from every background. The focus of the hospital management captures prioritizing the patient. By becoming a patient-centered hospital, the hospital's leadership vision would be to adopt the strategic leadership structure. Here the divisional hierarchical leadership to be embraced would enable every department of the hospital to work individually. This way, accountability would be measured by performance of the departments. This would consequently relate to the general performance of the hospital. In addition, the leaders would come to the realization that the authorities they exhibit can only be practiced as an office and not as an individual. Moreover, employees would be assigned roles that match their skills. Eventually, the employee satisfaction rates would be boosted due to the growth of individuals in their niche of practice (McLaughlin et al. 2012). The hospital management aims to adopt the four framework approach leadership model which proposes leadership exhibits behaviors that vary with varying situations. These behaviors can be represented in a four by four matrix, and they include human resource, structural, symbolic and structural frameworks. The structural framework focuses on strategies, implementation and adaptation of the strategies. This framework greatly suits an organization undergoing through change initiatives. The human resources framework involves empowering, supporting and sharing information with the employees. It suits advocacy and employee empowerment initiatives. The political framework embraces delegation, use of persuasion and negotiations as well as building associations with stakeholders. Finally, the symbolic framework involves interpretation of experiences and communication of organization visions (nwlink.com). Political framework Human Resources Framework Structural framework Symbolic Framework 3. 4. 3. The Problem Statement: current state of the organization and why this is a problem Currently, various complaints owing to delays in treatment have contributed mightily to loss of trust of patients in the immediacy of care at Moffick Hospital. The healthcare quality received by the patients is critical to the reputation of any healthcare organization. Patient safety is an inevitable to the delivery of quality service that needs to be assessed and evaluated on an annual or bi-annual basis. The reputation of Moffick Hospital as a specialist hospital and academic hospital relies heavily on the reputation it depicts to its users. The treatment delays and persistent low patient satisfaction scores are attributed to the high frequency of changes made to daily routines in nursing and patient care assignments. With the new vision and mission statements; it will be the obligation of persons in top level management of departments, the medical staff of the hospital, all the employees to work as a team and ensure the patients get a better deal. This would reiterate to more patients and greater image of Moffick Hospital. As an internationally recognized hospital, the management acknowledges that basic primary care plays a vital role in reducing inequalities in health and boosting outcomes of health. Good primary health care creates a positive impact all over the social and health care system of the nation. In addition, effective provision of these services plays an important role for delivering high quality and best health services which replicate in health economies. In order to be successful in the change initiative, the management aims at attaching promotion of equality for their patients. Patients would receive treatment regardless of their nationality or their status. Also, patients would be entitled to be provided with relevant information on everything they would enquire. This information would include the benefits and disadvantages of taking up one form of treatment or declining it. It would also include the average waiting time for particular treatments. In addition, employee satisfaction would be prioritized through various strategies to be identified below (McLaughlin et al. 2012). 4. The Statement of Significance: why it is important that the problem be addressed and who suffers in what way if not attended The significance of involving all the stakeholders in the problems identified mainly entails the need for universal contribution. Also, these stakeholders would help in addressing competition from hospitals in the locality which provide services that Moffick Hospital provides. The community hereby would help in raising issues that need to be undertaken in the delivery of health care. Consequently, the hospital would ensure equality of patients that attend this hospital. Moreover, empowering patients with information enable them to be partakers of the evidence-based strategy to be embraced. As a result, patient-provider relationship tends to be improved. 5. Literature Review: research on the problem and its potential solutions 5. The low patient satisfaction rates as unveiled by the various surveys are mainly due to: · Lack of routine internal patient acuity auditing · Poor feedback and communication between the medical staff and the patients and the medical staff and lower staff top patient ratios (Charmel & Frampton, 2008). The major setback mainly arose from the changes in the patient care model due to changes made to daily nursing and patient care assignments. The frequent changes to the routines contributed to slight resistance and reluctance from the staff owing to overlapping responsibilities. The short time frames set aside for implementation of change saw to it that wonderful strategies did not succeed. Citing a study done by Novikova, “A study of customer satisfaction factors and employee satisfaction in the hospitality industry”, various insights can be generated for implementation in Moffick Hospital. Changes made to our patient care model, staff scheduling, and increases in registered and advance nursing personnel will promote a more collaborative approach to patient care which may improve overall patient satisfaction (Charmel & Frampton 2008). Several studies have shown that there are many benefits to patient-centered care. These benefits could be classified broadly as clinical, care experience and operational benefits. Further studies provide evidence that when providers, healthcare administrators, families and patients work in as a team; the safety and quality of health care increases, costs drop, and provider as well as patient satisfaction increase (Stone, 2007). A study by Stone surveyed data for inpatient divisions at two parallel hospitals in the United States collected over five years. One hospital initiated a widespread strategy of patient-centered health care, while the other hospital maintained its status quo. The findings showed lesser Average Length of Stay (ALOS); reduced cost per case a shift in emphasis to affordable staff from higher cost personnel as well as improved patient satisfaction rates in the inpatient division. Similarly, Iacono replicated such results in a study conducted on patient satisfaction scales in twelve hospitals employing the Planetree method. (Stone, 2007) Institute for Patient- and Family-Centered Care (IPFCC), notes that patient-centered practices became the ultimate business model to be embraced in the Medical College of Georgia (MCG) Health System in Augusta, Georgia. This happens since it positively impacts the MCG’s corporate metrics (safety, market share, finances, satisfaction and quality). Over three years, data collected in the institute replicate an improvement in patient satisfaction, number of discharges, decrease in length of stay awaiting neurosurgery, decrease in medical error decreased by 62 per cent as well as decrease in staff resigning. In the overall, the perception of the clinical staff improved (Gress et al. 2006). 6. The Proposed Solution: including the statement of tangible, measurable objectives - i.e., future state I unveil a program which will champion the Moffick Hospital to the best position possible. The senior and middle management are greatly indebted to aligning resources within departments and ensuring that front line personnel design a strategy to enhance the patient’s experience. The success of this program significantly depends on individual accountability proprietorship and empowerment of the all the staff including the front line staff. Staff members with in-depth experience are empowered to engage newer staff who in turn should be willing to collaborate. Every senior management will be expected to generate newer departmental visions and mission statements whose appropriateness will be analyzed every year. The best department to achieve their vision and mission statements will receive an incentive which will be disclosed soon. Therefore, every staff member in every department needs to work in unison and improve on communication concerning areas that need amendments or otherwise. I have also opened a social media platform that will be a direct communication platform between the patients and the management. i) Patients As discussed in depth, Moffick looks forward to prioritizing patient safety and provision of quality health care. The patient-centered strategy aims at improving the patient satisfaction rates as well as improving the association between the hospital and its clients (McLaughlin et al. 2012). ii) Community The community would be required to u7se the channels established to provide their feedback, comments and complaints. This would help the management to identify sources and causes of low patient satisfactions (McLaughlin et al. 2012). iii) Employees The clinical staff in conjunction with the non-clinical staff need to consider proving patient-centered health care services. They also need to provide adequate information to their patients and their kin (McLaughlin et al. 2012). iv) Leaders and the BOG The BOG needs to create a working association with the employees of the hospital. This helps in identifying and rewarding best performances in addition to noting areas that should be addressed. On the other hand, the leaders need to acknowledge the leadership structure adopted as well the expectations of the position (McLaughlin et al. 2012). Stakeholder Analysis: the impact of change on various groups within and outside of the organization, their potential reactions, and how you will deal with each group as you move them through the change effort. The core area identified includes integrity, which mainly entails self-confidence, self-awareness, & Team Work. When the employees and staff employ such strategy, the leadership structure would consequently move in to enforce accountability and ownership. The expected balance would be results oriented as exhibited through focus on the impact anticipated upon success of the initiative, improving on the challenges as well as engaging stakeholders. The leaders would be required to draft the “direction” towards achieving the targets laid down. By doing this, they would need to counter tough decision making amidst empowering their subordinates to own the departmental vision. In addition, through collecting data and comments from the patients and the next of kin of the patients, the management would identify a niche in areas that need to be tapped into. The Moffick Hospital management hopes to cultivate the capability among its clients, staff members and the BOG. This would be done through encouraging individuals to perform to the best of their will in order to nurture innovation as well as enable growth through experience (Charmel & Frampton 2008). 7. Implementation Timeline: a graphical depiction of your implementation plan, with major milestones along the way. Implementation Timeline September 2014 – October 2014 November 2014- January 2015 February 2015- June 2015 July 2015- September 2015 inputs processes output outcomes Critical success factors 1. the stakeholders a. BOG b. senior management c. medical staff d. Hospital employees e. community 1. new departmental vision and mission statements 2. assess information needs 1. New departmental vision and mission statements 2. Feedback from patients 3. patient satisfaction surveys conducted daily Short term 1. better relations and communication between hospital employees and between patients and hospital employees 2. successful patient procedures 3. better patient receptacle at the facility 1.involvement of all the staff members in the new program 2.immense feedback from the public and staff members 3. prioritization of the patient’s wellbeing by the staff member 4. successful training of the staff 5. feedback on the communication channels 6. improved accountability and ownership among the staff members and physician engagement with patients 7. leadership support 2. communication channels for understanding of the new programme 3. ensure commitment by reassuring stakeholders to minimize reluctance and defiance 4. develop a monitoring and evaluation plan review 5. individual performance targets 6. departmental reports on adherence to individual targets 7. quarterly analysis of findings of the patient surveys Long term 1. better staffing and improved morale among staff 2. 3. shorter patient stays 4. 5. higher patient satisfaction rates 6. Impacts 1. positive reputation 1. Better training offered to the students 2. Critical success factors 1. Involvement of all the staff members in the new program involvement of the staff members would be measured through periodical employee satisfaction surveys. Once the mindsets of the employees shift become patient-centered approach and team work, more staff would be expected to be actively involved (McClean 2009). 2. Immense feedback from the public and staff members. To be provided by various organizations and individuals who are beneficiaries of Moffick Hospital (McClean 2009). 3. Prioritization of the patient’s wellbeing by the staff member As illustrated above, patient-centered health care provision would be emphasized alongside the new mission and vision statements. The means to determine success of this area would be through conducting exit surveys on patient satisfaction. This would help the management in benchmarking its progress towards success of the change initiative (McClean 2009). 4. Successful training of the staff The number of staff to be trained would be fully representative of the departments in the hospital. By training the staff before implementation of the project possibilities of resistance to change would be greatly minimized (McClean 2009). 5. Feedback on the communication channels 6. Improved accountability and ownership among the staff members and physician engagement with patients This mainly involves improving on health outcomes at Moffick Hospital. This involves improving health-related quality of life especially for longitudinal patients as well as those who suffer from chronic illnesses. In addition, the providers need to ensure that the patient gets the best experience of provision of care. This would in turn help in improving on the indicators (McClean 2009). 7. Leadership support This would be done through departmental reports on adherence to individual targets in addition to the quarterly analysis of findings of the patient surveys (McClean 2009). 8. Evaluation Method(s): how you will measure progress against set objectives and how you will know when you finally get "there". Patient flow is greatly determined by the wait times at the emergency time as indicated by various surveys conducted previously. Patient flow, on the other hand, depends on the patient satisfaction which is a valuable indicator in determining the quality of health care. Understanding patient needs and expectations increase patient satisfaction and better patient-physician engagement. In this program, evaluation of the outputs will be conducted in three stages. a) Diagnostic Evaluation This is supposed to be conducted prior to and during the early stages of a new program. This will include analysis of the appropriateness of training materials and venues for the few staff members who will be trained. The training should coincide with the learning styles and preexisting knowledge of the trainees (Rossi et al. 1999). b) Formative evaluation This is supposed to be undertaken in the 2nd and third phase of the implementation of the program. This will include determining how well the staff members are coping with the changes. It will also include addressing and setbacks resistance (Rossi et al. 1999). c) Summative Evaluation. Summative evaluation will be conducted in the last phase to determine success of the new program and ways on how to sustain the changes (Rossi et al. 1999). d) Longitudinal evaluation. This is to be conducted after the final phase to determine the sustainability of the program (Rossi et al. 1999). 9. Conclusion Under the new program, Moffick Hospital will prioritize patient satisfaction and higher quality of health care to its patients. I besiege all the stakeholders to work as a team since it’s the only best possible way to achieving success. REFERENCES: http://www.nwlink.com/~donclark/leader/leadmodels.html http://search.proquest.com/docview/305000386 http://search.proquest.com/docview/305025861 http://search.proquest.com/docview/304707366 http://search.proquest.com/docview/305052044 http://www.ncbi.nlm.nih.gov/books/NBK20490/ Charmel, P. & Frampton, S. (2008). Building the business case for patient-centred care. Healthcare Financial Management 2008;March(62 (3)):80-5. Foley, K. M., & Gelband, H. (2001). Improving palliative care for cancer. Washington, D.C: National Academy Press. Gress, D. R., Higashida, R. T., & Lawton, M. T. (2006). Controversies in neurological surgery: Neurovascular diseases. New York: Thieme Medical Publishers. Joint Commission on Accreditation of Healthcare Organizations. (2011). Comprehensive accreditation manual: CAMH for hospitals : the official handbook. Oakbrook Terrace, Ill: Joint Commission Accreditation. McClean, S. I. (2009). Intelligent patient management. Berlin: Springer-Verlag. McLaughlin, C. P., Johnson, J. K., & Sollecito, W. A. (2012). Implementing continuous quality improvement in health care: A global casebook. Sudbury, Mass: Jones & Bartlett Learning. Nelson, J., & Watson, J. (2012). Measuring caring: International research on caritas as healing. New York: Springer. Rossi, P. H., Freeman, H. E. & Lipsey, M. W. (1999). Evaluation: A Systematic approach. Thousand Oaks: Sage. Smith, J. (2000). Health management information systems: A handbook for decision makers. Buckingham [u.a.: Open Univ. Press. Stone, S. (2007) A Retrospective Evaluation of the Planetree Patient-Centered Model of Care Program's Impact on Inpatient Quality Outcomes [dissertation]. University of San Diego. Read More