Nursing Leadership and Management Field Experience
Project Proposal
Caroline Waweru
Western Governors University
Attached:
-A. Organization Approval Letter
-B. Preceptor Agreement Form
Nursing Leadership and Management Field Experience
The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is comprised of data sets, which are used to evaluate the quality of a hospital. Upon review of Winchester Hospital, it was evident that there is a continuing decline in the hospital’s HCAHPS scores. Winchester Hospital is in Winchester, Massachusetts, and is a well-recognized community hospital. With further review into the decline in HCAHPS scores, it was evident that the poor scores were a result of patient dissatisfaction in their hospital experience. With this understanding of the problem within the facility, this registered nurse (RN) will propose a plan to improve the hospitals HCAHPS scores. To do so, the proposal is to start leadership rounding, which will improve patient satisfaction by reassuring them that their needs are met, and as a result, improve HCAHPS scores.
Description of Problem
Due to the hectic workload in the healthcare facility, there has been a shortage of good and clear communication within the providers, nurses, and patients. Communication problems can result in patient harm, but in this scenario, it is contributing to poor patient satisfaction in their care and resulting in poor satisfaction scores. Lack of communication among the healthcare team, as well as lack of communication between the healthcare team and their patients, is a major barrier to providing quality care for patients and their families. The HCAHPS survey results provide significant evidence to indicate the need to improve the present level of communication between healthcare practitioners, patients, and their caregivers in order to improve the current scores.
The primary goal of patient-centered care is to treat the patient’s illness. If a patient is hindered in any way to effectively communicate the reason for their hospital visit, this can affect their length of stay, their ability to receive education regarding their medical conditions, and their ability to access appropriate medical resources to treat the conditions. These communication barriers will likely result in lower HCAHPS scores for that hospital (Dempsey, Wojciechowski, McConville, & Drain, 2014). The lack of communication between the healthcare staff and the patients results in unsatisfactory patient care and, ultimately, the hospital will suffer from the resulting patient outcome. It is the duty of the hospital, as a healthcare center, to look out for the needs of their patients, and moreover, they are also responsible for monitoring the staff work performance and any contributive factors hindering excellence within the care they are providing to their patients. In order to maintain exceptional HCAHPS scores, it is crucial that hospitals do not earn the non-satisfaction of their patients by short staffing or limiting the quality of care.
According to McFarland, Shen, Parker, Meyerson, & Holcombe (2017), hospitals where nurses have a better work environment, more favorable staffing ratios, and better general collaboration with the physicians, demonstrate vastly improved patient and healthcare staff satisfaction. This is another area where Winchester Hospital needs improvement. The hospital’s working environment is not ideal, the nurse to patient ratio needs improvement, and the collaboration of the nurses with physicians remains unsatisfactory. If these concerns were addressed and improved, the nurses would be able to provide better care to their clients since each nurse will have more time to spend with a patient and, thus, provide unrushed care. As a result, the improved nurse workplace fulfillment in the care they are providing will lead to improved patient care satisfaction and, in turn, result in enhanced HCAHPS scores.
Explanation of Causes
The primary goal of both for-profit and non-profit health institutes is to protect, maintain, and restore the population’s health. Secondly, they must maintain a balance between the revenue and costs involved. However, in their efforts to pursue these goals, most healthcare practitioners tend to forget that there exists a delicate balance between quality and quantity. In the long run, they tend to divert their attention from the quality of the services they provide to the number of patients they serve. As a result, the hospital ends up operating below the hospital’s consumer assessment and expectations of healthcare, which ultimately impacts the HCAHPS score in the facility. Compared to most healthcare centers in the United States, the performance of Winchester Hospital is below average. This is because of a lack of effective communication within the hospital, along with a rapid decrease in the level of health care services, which are two of the most crucial factors for the welfare of the patients and the health care organization (Dempsey, Reilly, & Buhlman, 2014). The reality of the matter in hand is, clinicians, nurses, and other members of the interdisciplinary team do not spend enough time conversing with their patients nor do they spend enough time communicating with each other. Time constraints have played a major role in this matter. If health care workers, at the forefront involvement in the patient care, can spend enough time with other team members and their patients, then this will result in better patient outcomes as well as lead to an overall improvement in patient experience within the hospital. In this respect, leadership rounding can be very helpful to achieve the goal of enhancing the overall patient experience. As the interdisciplinary team comes together during the rounding process, they can discuss the patient’s current diagnosis and plan of care. While doing so, the patient is also present and involved in the discussion, which allows the patient to feel as though they are involved and have input on their care. With leadership rounding, communication barriers are addressed and minimized. With better communication, there will also be fewer medical errors which will minimize the average length of stay within the hospital and, as a result, reduce unnecessary hospital expenses.
Identification of Stakeholders
Stakeholders, in an organization, hold power and their interests can influence change in an organization in various capacities. Each stakeholder can represent a different set of ideas and possess different capacities. Thus, incorporating their views during the decision-making process would aid with supporting the process that can bring change. There are three primary stakeholders in this problem/proposal in Winchester hospital, which include the facility’s nursing supervisors, providers, and patients.
Discussion of Stakeholders
Patients have the power to influence the hospital’s overall perspective of healthcare and safety by means of the HCAHPS. The medical staff, which includes health care providers and nurses, have a major role in providing medically effective services for their patients. If they enhance their skills and communication abilities, then they can easily improve their capabilities to provide effective health care services (Dempsey, Reilly, & Buhlman, 2014). Nurses have the responsibility to provide satisfactory care to the patients and support to aid them in returning to health during their illness. This effective care has the potential to increase the overall HCAHPS scores. When it comes to the primary interest of nurses, as one of the main stakeholders, it is important to establish that effective and quality patient care will ultimately enhance the nursing performance level as well.
Patient satisfaction controls the HCAHPS scores, while it is job performance that should remain important for both the physicians and the nurses (Rodriguez-Osorio & Dominguez-Cherit, 2008). While physicians have a strong role to play in the wellbeing of patients, however, every patient is virtually responsible for his or her own wellbeing (Bodenheimer, Lo, & Casalino, 1999). Thus, if patients work in tandem with the physicians and nurses in taking care of their needs, then they will be able better connect with their providers and engage in shared decision-making with regards to their care. This system would work rather well and the performance of the hospital, along with the HCAHPS score, would improve.
The Healthcare Providers
Providers have the capacity to bring about successful change in their patients and the staff. Moreover, they can influence other providers on what path to take in providing care to their patients. Their main interest is the improved outcomes of their patients, but at the end of it all, the biggest outcome is also their reputation. Having a great reputation for patient care outcomes brings greater recognition for providers and the hospital. Lastly, providers have the utmost power in the healthcare facility; they decide on admitting patients, devise the plan of care, and determine the discharge timeline as well. Providers set the plan for the patients and the staff to follow and confirm that those goals have been met. Thus, to achieve these objectives, healthcare providers need to embrace strategies that aid their efforts for improving efficiency in the workplace. They also have the technical know-how, knowledge, and scope, which allows them to understand the challenges faced by the healthcare facility. They also can initiate the proper methods of intervention which are needed, thus giving them the power to influence and bring about change in an organization.
Patients
The second group of stakeholders that have a significant interest in the matter is the patients. All activities undertaken by any healthcare facility revolve around patients. Access to services and affordability of care are two areas that patients consider while seeking healthcare services. They usually gather all the required information and decide where to seek care based on the information they have received. This information is usually accessed using the hospital’s publicly available healthcare data or by the experience of other patients who have visited the hospital. A hospital’s process improvement system empowers the patients by using their input to promote change in the areas that are lacking in the provision of quality healthcare services. For instance, the implementation of Health Insurance Portability and Accountability Act (HIPAA) requires healthcare organizations to not only store their patient records electronically, but it also prohibits sharing of that information without the patient’s consent. Patients have an influence in bringing about change based on their feedback. In this proposal, it seems clear that change needs to occur due to the low HCAHPS scores, which indicates an overall lower patient satisfaction experience. Patients can promote change by protecting their own primary interest, which is to receive the best care for themselves and their loved ones and, thereby, achieve their ultimate goal.
Nursing Supervisors
The final group of stakeholders, that have a direct impact on the improvement of hospital services, is nursing supervisors. Besides playing a managerial role in the system, they also have the power to restore, promote, and sustain the health of the public. Their interest is to provide the utmost care to their patients, but to do so, they must ensure that nurses are well-trained and skilled in providing the necessary care. The nursing supervisors can influence their staff in a positive or a negative way. This influence requires clear communication and dialogue between the supervisors and staff, thereby allowing concerns to be met and addressed. If staff receive the necessary training and feel confident and competent in their skills and abilities, they are more likely to perform at their best. Nursing supervisors are the ones that control the various resources used in a healthcare facility as they can determine how and where these sources can be utilized. They can also use their economic power to influence a positive change in the system. This gives them the authority to sanction a project, while rejecting another, depending on whether not or the initiative being taken is feasible for that facility.
Explanation of Project
Clinical Leaders need to improve the quality of health care services provided by the organization, which can lead to higher HCAHPS scores. The leaders play a critical role in health care organizations, as they are responsible to improve the quality of care, by influencing staff performance. Their presence in the patient care setting is beneficial to encourage others and enhance their performance. The leaders have the power to influence the performance level of all the staff (not just to nurses), with the objective of providing better healthcare services for the patients. Leadership rounding serves as the frontline of providing care to meet the patient’s needs. When there is clear communication between the leaders and the staff regarding patients’ needs, this minimizes problems from occurring. The rounding serves as a proactive strategy to promote patient care. Leadership rounding has previously been proven to be very effective in achieving favorable patient care outcomes (Morton, Brekhus, Reynolds, & Dykes 2014). As a result, patients provide positive feedback on their hospital experiences which will likely increase the hospitals HCAHPS scores. Higher HCAHPS scores mean better hospital reputation, increased funding, and greater reimbursement potential. The patient plays an integral role in the healthcare organization for the management of their own health. Patients have the right to speak up and ask questions about their plan of care. Meeting the needs and expectations of patients, in the health care organization is the most effective method to improve the HCAHPS scores.
Purpose of the Project
The purpose of this project is to make a proposal to incorporate leadership rounding, as a daily routine, within Winchester Hospital. This will address patient satisfaction concerns and the challenges that are being faced at Winchester hospital. Lack of clear communication between nurses and patients is hindering the provision of quality health care services. The healthcare providers at the hospital, along with the nurses, are not providing the most satisfying care for their patients. This leaves the patients and caregivers unsatisfied with the care being provided, directly impacts the HCAHPS score of Winchester hospital. As previously stated, lower patient satisfaction leads to lower HCAHPS scores which, in turn, leads to a decrease in patient reimbursement. Therefore, the goal of the leadership rounding is to clearly understand the patient’s needs, then communicating those needs with the staff and as a result, they are appropriately addressed.
Proposed Solution
There is a primary need to implement effective practices in health care organizations, in order to improve the quality of health care. Leadership rounding is one of the most effective strategies, to help highlight the areas of improvement within the hospital. Rounds taken by the leaders are beneficial to understanding the concerns of patients and their families ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"uPjEJPRV","properties":{"formattedCitation":"(Morton, Brekhus, Reynolds, & Dykes, 2014)","plainCitation":"(Morton, Brekhus, Reynolds, & Dykes, 2014)","noteIndex":0},"citationItems":[{"id":"hK3MTZyl/IHuPgUc4","uris":["http://zotero.org/users/local/0omESN17/items/DJKD7JHZ"],"uri":["http://zotero.org/users/local/0omESN17/items/DJKD7JHZ"],"itemData":{"id":72,"type":"article-journal","title":"Improving the patient experience through nurse leader rounds","container-title":"Patient Experience Journal","page":"53-61","volume":"1","issue":"2","author":[{"family":"Morton","given":"Judy C."},{"family":"Brekhus","given":"Jodi"},{"family":"Reynolds","given":"Megan"},{"family":"Dykes","given":"Anna Kay"}],"issued":{"date-parts":[["2014"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Morton, Brekhus, Reynolds, & Dykes, 2014). By understanding the problem, leaders are capable of proposing solutions to improve the overall health care services in the organization. It is notable to mention that rounds taken by the leaders promote a sense of satisfaction in patients, which can ultimately improve the overall HCAHPS scores of Winchester hospital ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"fuDnqGVz","properties":{"formattedCitation":"(Merrifield, Frier, Lewis, & Walker, 2016)","plainCitation":"(Merrifield, Frier, Lewis, & Walker, 2016)","noteIndex":0},"citationItems":[{"id":"hK3MTZyl/4PGAKSn3","uris":["http://zotero.org/users/local/0omESN17/items/ZGSLE4LX"],"uri":["http://zotero.org/users/local/0omESN17/items/ZGSLE4LX"],"itemData":{"id":73,"type":"article-journal","title":"Improving care and accountability in a busy Emergency Department through the use of intentional rounding: The journey so far","author":[{"family":"Merrifield","given":"Josephine"},{"family":"Frier","given":"Rosemarie"},{"family":"Lewis","given":"Lydia"},{"family":"Walker","given":"Emma Jayne"}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Merrifield, Frier, Lewis, & Walker, 2016). The leadership rounding also promotes a dialogue between the staff and the patients.
Evidence Summary
Nursing, as a profession, serves an important role in the healthcare system. The care, provided by nurses, plays a significant part in determining the health and well-being of patients admitted to a healthcare facility. However, the existence of communication barriers between nurses, providers, and patients, has significantly affected the quality of services provided, as well as the safety associated with these services ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"VHC0F6wr","properties":{"formattedCitation":"(Bender, 2016)","plainCitation":"(Bender, 2016)","noteIndex":0},"citationItems":[{"id":154,"uris":["http://zotero.org/users/local/0omESN17/items/83WCBBR2"],"uri":["http://zotero.org/users/local/0omESN17/items/83WCBBR2"],"itemData":{"id":154,"type":"article-journal","title":"Clinical nurse leader integration into practice: developing theory to guide best practice","container-title":"Journal of Professional Nursing","page":"32-40","volume":"32","issue":"1","author":[{"family":"Bender","given":"Miriam"}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Bender, 2016).
Leadership rounding is an effective strategy that improves overall patient satisfaction. It involves direct observation and evaluation of the patient, staff, clinical environment, unit operations and overall global view of patient status. Additionally, it provides opportunities to improve patients outcomes by listening to their concerns ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"XIDnOvNs","properties":{"formattedCitation":"(Reimer & Herbener, 2014)","plainCitation":"(Reimer & Herbener, 2014)","noteIndex":0},"citationItems":[{"id":"hK3MTZyl/PeJ1pQ9w","uris":["http://zotero.org/users/local/5VyEEXyp/items/Y2R6ZCFC"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/Y2R6ZCFC"],"itemData":{"id":67,"type":"article-journal","title":"Round and round we go: rounding strategies to impact exemplary professional practice.","container-title":"Clinical journal of oncology nursing","volume":"18","issue":"6","author":[{"family":"Reimer","given":"Nicole"},{"family":"Herbener","given":"Laura"}],"issued":{"date-parts":[["2014"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Reimer & Herbener, 2014). The rounds made by the leaders, on a day to day basis, are valuable for proactive assessment regarding quality of care, and the care they provide to the patients under their charge. This assessment of quality helps in providing immediate feedback to staff. Rounds taken by the Leaders provide patients with the chance to share their concerns without restrictions ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"tYwCJxsR","properties":{"formattedCitation":"(Harris, 2012)","plainCitation":"(Harris, 2012)","dontUpdate":true,"noteIndex":0},"citationItems":[{"id":112,"uris":["http://zotero.org/users/local/0omESN17/items/7D92ZLEI"],"uri":["http://zotero.org/users/local/0omESN17/items/7D92ZLEI"],"itemData":{"id":112,"type":"book","title":"A teaching subject: Composition since 1966","publisher":"University Press of Colorado","ISBN":"0-87421-867-5","author":[{"family":"Harris","given":"Joseph"}],"issued":{"date-parts":[["2012"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Harris, 2016).
According to Merrifield et al. (2016), the efficiency of rounds taken by the unit leader enhances the facility’s capability to deliver effective care. Leaders and managers, working in a healthcare system, must focus on addressing many issues at hand. This allows them to focus on the well-being of their patients while ensuring the proper functioning of the hospital. They understand a leader can utilize this practice to move staff, mission, and goals in order to ensure the delivery of safe and high-quality practices. The practice of leadership rounding creates a sense of awareness among the patients and ensures that the unit leaders prioritize their health and well-being above all else ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"VSiYBwqG","properties":{"formattedCitation":"(Denker, Sherman, Hutton-Woodland, Brunell, & Medina, 2015)","plainCitation":"(Denker, Sherman, Hutton-Woodland, Brunell, & Medina, 2015)","noteIndex":0},"citationItems":[{"id":153,"uris":["http://zotero.org/users/local/0omESN17/items/WC8ZAVKM"],"uri":["http://zotero.org/users/local/0omESN17/items/WC8ZAVKM"],"itemData":{"id":153,"type":"article-journal","title":"Florida Nurse Leader Survey findings: key leadership competencies, barriers to leadership, and succession planning needs","container-title":"Journal of Nursing Administration","page":"404-410","volume":"45","issue":"7/8","author":[{"family":"Denker","given":"Ann-Lynn"},{"family":"Sherman","given":"Rose O."},{"family":"Hutton-Woodland","given":"Michael"},{"family":"Brunell","given":"Mary Lou"},{"family":"Medina","given":"Pamela"}],"issued":{"date-parts":[["2015"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Denker, Sherman, Hutton-Woodland, Brunell, & Medina, 2015). This also fosters a sense of comradery between the healthcare team and the patient, allowing patients to share their feelings in an appropriate manner when they believe that unit leaders are concerned about their wellbeing ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"UGnhYWrl","properties":{"formattedCitation":"(Walker, Duff, & Fitzgerald, 2015)","plainCitation":"(Walker, Duff, & Fitzgerald, 2015)","noteIndex":0},"citationItems":[{"id":"hK3MTZyl/KvpICm9w","uris":["http://zotero.org/users/local/5VyEEXyp/items/J7EYA82G"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/J7EYA82G"],"itemData":{"id":70,"type":"article-journal","title":"‘Rounding’for better patient care: An evaluation of an improvement intervention implementation","container-title":"International journal of nursing practice","page":"207-213","volume":"21","issue":"2","author":[{"family":"Walker","given":"Kim"},{"family":"Duff","given":"Jed"},{"family":"Fitzgerald","given":"Katherine"}],"issued":{"date-parts":[["2015"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Walker, Duff, & Fitzgerald, 2015).
Open communication with patients helps leaders to better understand the patient’s hospital experience. It provides valuable insights, regarding knowledge gaps, that need to be reinforced, to improve patient understanding of their care, ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"0VOHCjMq","properties":{"formattedCitation":"(Dempsey, Reilly, et al., 2014)","plainCitation":"(Dempsey, Reilly, et al., 2014)","noteIndex":0},"citationItems":[{"id":"hK3MTZyl/ckhbM0pL","uris":["http://zotero.org/users/local/0omESN17/items/BVZ4W6S7"],"uri":["http://zotero.org/users/local/0omESN17/items/BVZ4W6S7"],"itemData":{"id":"EmFT1DOb/zYRUllb7","type":"article-journal","title":"Improving the patient experience: real-world strategies for engaging nurses","container-title":"Journal of Nursing Administration","page":"142-151","volume":"44","issue":"3","author":[{"family":"Dempsey","given":"Christina"},{"family":"Reilly","given":"Barbara"},{"family":"Buhlman","given":"Nell"}],"issued":{"date-parts":[["2014"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Dempsey, Reilly, et al., 2014). A leader must strive to improve the care provided to patients, and as a result, higher HCAHPS scores may be obtained for the facility. The leaders, while performing rounds, also serve as role models for the unit staff, especially in demonstrating effective communication skills (Walker, Duff, & Fitzgerald,2015). Emphasizing the importance of leadership rounding can improve the collaboration and clear communication among all healthcare team members (Morton et al, 2014). This demonstrates the significant role that leadership rounding can have in eliminating communication barriers, which hinders the optimal capacity of nurses to provide effective healthcare services. Based on the evidence reviewed, in the literature, the plan to implement leadership rounding was identified as a plan to resolve patient dissatisfaction. When patient care and outcomes are improved, this will likely result in higher HCAHPS scores, which is the end goal.
Plan of Action
In order to improve the health care services of Winchester Hospital, it is necessary to implement the practice of leadership rounding. Daily rounds taken by the leaders will help to identify areas for improvement at Winchester Hospital. Once problems have been identified, proposed solutions can be developed to address and improve the health care services, in order to increase HCAHPS scores. Proper communication is an essential component to implement and maintain during the entire process of leadership rounding. The leaders need to connect with an entire team of competent nurses to meet the standards of health care services ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"6tAEPqh8","properties":{"formattedCitation":"(L. A. Stokowski, 2014)","plainCitation":"(L. A. Stokowski, 2014)","noteIndex":0},"citationItems":[{"id":150,"uris":["http://zotero.org/users/local/0omESN17/items/MLQABWCB"],"uri":["http://zotero.org/users/local/0omESN17/items/MLQABWCB"],"itemData":{"id":150,"type":"book","title":"The risky business of nursing","author":[{"family":"Stokowski","given":"L. A."}],"issued":{"date-parts":[["2014"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Stokowski, 2014). This specific objective can only be achieved through a clear understanding of staff and patient needs.
Step One
The author will meet with others to discuss the problem of low HCAHPS at Winchester Hospital. Lower HCAHPS scores are associated with dissatisfaction in patient care, which has been identified at this facility. This author will meet with the preceptor and discuss contributing factors of low HCAHPS scores within this facility. We will also discuss the location and time to generate potential strategies to implement leadership rounding.
Step Two
The author will begin an evidence-based literature search and review, by collecting peer-reviewed articles. Collected reviews will be published within the past five years. This review will focus on the evidence and the benefits that support the proposal of leadership rounding, to manage the low HCAHPS facing this facility.
Step Three
The author will draft a proposal for leadership rounding. In the proposal, the author will include three stakeholders to involve: the patients, providers, and nursing supervisors.
Research will guide this author in clearly identifying the problem and solution strategies, in order to generate an effective proposal. This strategy will focus on the stakeholders and their roles in the leadership rounding process.
Step Four
This author will present the draft proposal to the preceptor. The preceptor will review the draft provided by the author and ask questions for clarification, as needed. The preceptor will provide feedback regarding the draft proposal and will suggest any additional content that may be needed. With preceptor feedback, the author will revise the final draft.
Step Five
The author will arrange a meeting with the preceptor and nurse supervisor and present the leadership rounding proposal. A date and time will be determined for the presentation of this proposal. An appropriate location to deliver the proposal will be reserved.
Timeline
The plan for this proposal is to provide and work within a well-vetted timeline to reform the system at Winchester Hospital. The timeline for delivering this graduate student capstone project will be based on the below timeline.
Week One
The author will meet with others to discuss the problem of low HCAHPS at Winchester Hospital. Low HCAHPS scores are associated with dissatisfaction in patient care, which has been identified at this facility. This author will meet with the preceptor and discuss contributing factors of low HCAHPS scores within this facility. We will also discuss the location and time to generate potential strategies to implement leadership rounding.
Week Two
The author will begin an evidence-based literature search and review, by collecting peer-reviewed articles. Collected reviews will be published within the past five years. This review will focus on the evidence and the benefits that support the proposal of leadership rounding, to manage the low HCAHPS facing this facility.
Week Three
The author will draft a proposal for leadership rounding. In the proposal, the author will include three stakeholders to involve; the patients, providers and nursing supervisors.
Research will guide this author in clearly identifying the problem and solution strategies, in order to generate an effective proposal. This strategy will focus on the stakeholders and their roles in the leadership rounding process.
Week Four
This author will present the draft proposal to the preceptor. The preceptor will review the draft provided by the author and ask questions for clarification, as needed. The preceptor will provide feedback regarding the draft proposal and will suggest any additional content that may be needed. With preceptor feedback, the author will revise the final draft.
Week Five
The author will arrange a meeting with the preceptor and nurse supervisor and present the leadership rounding proposal. A date and time will be determined for the presentation of this proposal. An appropriate location to deliver the proposal will be reserved.
Required Resources and Personnel
Implementing the proposed change requires various resources and personnel. The project needs time, and staff support to organize a proposal event. The personnel needed to facilitate smooth implementation of the proposed plan, include; preceptor, audiovisual staff and nurse supervisors. Resources include a projector and copying machine and papers to make handouts for the audience. Essentially, the proposal will require requesting a conference room, which of course is based on the availability as it is constantly in use. Waiting for the available conference room might take time as it has been previously booked. Upon receiving confirmation of the availability of the conference room day, it will be necessary to make copies of the proposal to distribute to the attendees. The proposal will be displayed via PowerPoint, as this will make it easier for the attendees to follow step by step. Since the individuals, which include the preceptor and the nurse supervisor, who are required to attend have varying schedules; it may be necessary to make two different sessions to accommodate the individuals' availability based on their schedules.
Proposed Change Theory
The change theory used is Lewins three-stage model of change, this is known as an unfreezing-change-refreeze model. It is important for this graduate student to focus on different stages of the change theory in order to better execute this capstone project proposal. The first stage known as unfreezing took place when this author and preceptor identified the problem in this facility. It was concluded after analyzing several areas there was a need to propose a leadership rounding process, to promote patient satisfaction which will improve HCAHPS scores. The second stage will include further investigation on how to implement the proposal. This will be done by reviewing numerous peer-reviewed literature articles to support the change. In this area, this graduate student will be able to draw ideas to assist in creating this proposal. Finally, in the refreezing stage, the proposal will be delivered to the nursing supervisor, with evidence for how the leadership rounding process would benefit the unit. When it comes to the perspective of change theory, it is widely considered a concept to determine better forms of healthcare services for the patients through the perspective of nursing. The concept of change theory is comprised of three important stages which helps to identify the necessity for change. Exploration of the need for change helps decision-makers to develop better strategies to apply suitable practical measures and to enhance the aspect of quality healthcare (Petiprin,2016).
Barriers of Implementation
With every new change, there are always barriers encountered. In this topic, there are several obstacles that may be encountered, these may include lack of time, due to the hectic schedules between supervisors and preceptor, it may be difficult for them to coordinate a time to attend the presentation, as they do have busy schedules. Secondly the inconvenience in scheduling a conference room, currently there is only one conference room and it is always in great demand. The room is frequently reserved and involves long wait times before allowing access inside which, in turn, may prolong the presentation. Lastly, with every new idea, not everybody may be welcoming the thought of new concepts. Many individuals are stuck in their own ways and do not welcome change well, instead, they rather contest rather than attempting to understand the logic of the proposal It is great to realize, there is always room for improvement in every situation and we should be proactive members to better ourselves and those we care for as well.
References
ADDIN ZOTERO_BIBL {"uncited":[["http://zotero.org/users/local/0omESN17/items/948FNQ9Z"]],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Bender, M. (2016). Clinical nurse leader integration into practice: developing theory to guide best practice. Journal of Professional Nursing, 32(1), 32–40, https://doi.org/10.1016/j.profnurs.2015.06.007
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