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Sample Essay Paper on Organizational Leadership and Interprofessional Team Development

Organizational Leadership and Interprofessional Team Development

Healthcare is a critical but complicated system. The sector entails economic processes, adherence to regulatory requirements, and quality indicators that are not found in traditional business settings. As such, leaders within the healthcare industry at all levels must develop unique sets of skills that relate to organizational leadership and interprofessional team development. As the healthcare industry’s complexity increases, it is essential to understand the comprehensive approach to patient care management across the continuum. It is also critical to understand how the concepts of organizational leadership and team development help leaders in the creation of a patient-centric environment.

Business Practices Impact on Patient and Family-Centered Care

Business practices, regulatory requirements, and reimbursement affect how healthcare organizations provide patient- and family-centered care. These organizations’ focus is usually on how to include patients and their families in the provision of care. In this regard, they integrate methods they believe are not only efficient but also effective. Business practices in healthcare settings might include changing visiting hours to ensure that provision of care to patients faces minimal interruption. This is similar to the situation in traditional business settings where people have to schedule appointments with employees or manager. Changing visiting hours improves the quality of care provided to the patient.

Regulatory requirements imply that healthcare organizations have no alternative but to offer patient- and family-centered care that is in line with set regulations. An example of regulatory requirements is proper licensure of care providers and other personnel offering crucial services across healthcare settings. It is mandatory for care providers to have the right qualifications such as the right documentation and evidence that they passed the necessary tests. These requirements ensure that quality and safe care is provided to patients. Furthermore, they ensure that reimbursement to facilities are warranted. Failure to adhere to regulatory requirements can result in the withdrawal of license or closure of a healthcare facility.

Reimbursement usually determines the amount of funds given to a provider for services offered to patients. In the U.S., organizations such as the Centers for Medicaid and Medicare Services (CMS) play a key role in reimbursing care providers in both public and private healthcare facilities. An impact of reimbursement on patient-centered acre is that it oversees and ensures the improvement of patient safety and outcomes. This is achieved through imposing penalties to healthcare organizations that exhibit poor performance outcomes (Roussel, 2012). Moreover, the CMS is charged with setting guidelines on how patient-centered care should be improved.

Patient- and Family-Centered Care Organizational Self-Assessment Tool

Setting Description

The healthcare setting selected for assessment is Cedars-Sinai Medical Center. The facility is a non-profit healthcare setting with a bed capacity of 886 and boasts a Level I Trauma Center as well. It is located in Los Angeles, California. It is a huge setting given that it serves around 256,075 patients. Out of this patient population, Hispanics or Latinos account for 49.6 percent, Caucasians account for approximately 19.7 percent, African Americans account for 18 percent, Asians account for 10.1 percent, American Indians account for 0.2 percent, Native Americans account for 0.1 percent, while other ethnicities or races account for 2.4 percent. CSHS provides a wide range of healthcare services that include general patient care, neurosurgery, cardiac, and orthopedic among others. The facility has around 2,166 physicians who work hand in hand with 3,363 nurses (Cedars-Sinai Medical Center). The facility’s primary focus is to provide quality and safe care to every patient who visits.

Strengths and Weaknesses

Leadership/Operations

In this domain, the organization’s major strength is the provision of a clear statement of commitment to patient- and family-centered care, which is highlighted in its mission statement. Weaknesses are from the perspectives of patient/family inclusion in policy, procedure, program, guideline development, governing board activities, as well as explicit expectation, accountability, and measurement of patient family-centered care.

Mission, Vision, Values

The organization’s strengths include clear vision and mission statements that express commitment to patient-centered care. These include “offering compassionate care and high-value care” and “leading the U.S. in the delivery of excellent clinical quality, patient safety, and service”. Another strength is the Patient Bill of Rights that is stated in the admissions paperwork of patients. There are no evident weaknesses in this domain.

Advisors

One of the strengths is the patient/family participation in quality and safety rounds. In most cases, family members should be present during morning rounds and there should be a team that gathers and discusses the plan of care and treatment of the patient. Weaknesses are that patient/family do not serve on hospital committees and there are no patient/family advisory councils.

Quality Improvement

A strength in this domain is that the Chief Nursing Officer performs day-to-day rounds and holds talks with patients and family about their experiences. Issues that arise are then discussed immediately. There are four major weaknesses: patient/family voice does not inform strategic/operational aims or goals; patients/families are not active participants on task forces, QI teams; patient/family do not participate in quality, safety, and risk meetings; and patient/family are not part of team attending IHI, NPSF, and other meetings.

Personnel

The organization’s strength in this domain is that physicians and staff undergo training and are prepared and supported in patient/family-centered care practice. There are three major weaknesses in this regard. The organization does not have patient/family participants on interviews, search committees; patient/family do not welcome new staff at new employee orientation; and they are not involved in job descriptions and policies in performance appraisal process.

Environment and Design

In this domain, a strength for Cedars-Sinai is that it has a strong patient/family presence in interdisciplinary collaboration. It offers a healing environment for both the patient and family. Collaboration is evident during patient admission during which all parties are involved in patient care. A weakness is the lack of evidence showing that patient/family take part in clinical design projects.

Information/Education

There are three major strengths of the organization in this domain. Patient/family have access to web portals to obtain specific resources; they can email clinicians through a safe and secure network; and they are encouraged to use resource rooms. A weakness of the organization in this domain is that patient/family do not serve as educators or faculty for clinicians and other staff.

Diversity and Disparities

The organization has three major strengths in this domain. These include careful collection and measurement of race, ethnicity, and language; patient/family are allowed timely access to interpreter services; and there are navigator programs for minority and underserved patients. A major weakness is that education materials are not at appropriate or per the required literacy levels.

Charting and Documentation

A strength of the organization in this regard is that patient/family have full and easy access to paper or electronic record. A weakness is that patient and family have limitations on what they can document in their charts. For instance, they cannot complete pre-registration before hospital admission or doctor’s appointment.

Care Support

There are five major strengths of the organization in this domain.  Family members of care team have 24-hour seven days a week access to the facility; families can stay, join in rounds and change of shift report; family presence is allowed or supported during rescue events; patient/family find support, disclosure, and apology with error and harm; and patients receive updated medication history during every visit. A weakness is that patient/family cannot activate rapid response systems.

Care

The strengths of the organization in this domain are that patient/family engage with clinicians in collaborative goal setting; patient/family are listened to, respected, and treated as partners in care; families are actively involved in care planning and transitions; and pain is respectively managed in partnerships with patient and family. There are no major weaknesses of the organization with regard to care.

Area of Improvement

Following the assessment of the organization using the self-assessment tool, various strengths and weaknesses were evident. However, the area or domain that requires improvement is that of advisors. Out of the three elements in the domain, the organization lags behind in two elements: patient/family do not serve on hospital committees and neither are there patient/family advisory councils. The only strength of the organization in this domain is that patient/family are allowed to participate in quality and safety rounds.

Improvement Strategy

To increase patient-centeredness with regard to the weaknesses in the advisors domain, creation of a multidisciplinary team is mandatory. Such a team should consist of five key personnel including a representative of the patient/family, a representative from the administration, a nurse, a physician, and a project manager.  The multidisciplinary team will give their opinions and suggestions on what can be done to ensure that the organization allows patient/family to serve on hospitals and that patient/family advisory councils are created. The team’s agreement on these two key issues will pave the way for increased patient-centeredness.

System or Change Theory

A change theory that would be applied in the development of the above improvement strategy to address the weaknesses in the advisors domain is the Lewin change model. The model entails a three-step proves of unfreezing, changing, and unfreezing (Kritsonis, 2005). This model will guide the team in the commitment to ensure that patient/family serve on hospital committees and that patient/family advisories are created. In the unfreezing step, the team will brainstorm and understand why change has to take place as far as the two weaknesses are concerned. Team members will determine ways of ensuring that patient/family are part of hospital committees and advisory councils.  In the changing step, the team will review evidence of other healthcare organizations that have successfully included patients/families in hospital committees and advisory councils. The data and information obtained will then be used to initiate change. In the unfreezing step, the team will come up with new policies and procedures to guide the incorporation of patients/families into hospital committees and advisory councils.

Financial Implications

The implementation of the strategy might have financial implications on the organization. For instance, a decision may be made that meetings among team members be held outside the organization and outside the regular working hours implying that financial compensation must be given to team members. Moreover, the implementation of the strategy could require resources in the form of multimedia equipment, human labor, and paper among others, which will require the organization to pay.

Method of Evaluating Effectiveness of Strategy

A method that will be used to evaluate the effectiveness of the strategy in increasing patient-centered care is holding community outreach forums that will have representatives from the team and outside. The representatives will then ask members of the public, particularly patients, to give their opinions on whether patient-centered care has increased or not, following the implementation of the strategy. Another method of evaluation is conducting a survey to ask various groups how valuable having patients/families on hospital committees and advisory councils is. The feedback from the surveys will help in determining whether the new implementation is of value to the healthcare facility. If it is determined to be of value, the healthcare facility could decide to create more opportunities and spaces in hospital committees and advisory councils going forward.

Multidisciplinary Team

The multidisciplinary team that will assist in implementing the strategy will comprise of an administrator, nursing staff, physician, project manager, and representative of the patient/family. The administrator will ensure that the team makes decisions that comply with regulations such as that requiring involvement of patients/families on hospital committees and advisory councils. The nurse will give guidance regarding the development of procedures and policies regarding the involvement of patient/family on hospital committees and advisory councils. The physician will give insight into care enhancement through the involvement of patient/family and get an idea of strategies used by other physicians. The project manager will oversee the arrangement of meeting venues and time and ensure the availability of required equipment. The patient/family representative will help to identify what committees or advisory councils ought to be created that will meet the needs of the patient/family.

Team Diversity

Cultural diversity will be fundamental for the multidisciplinary team that will be responsible for the implementation of the strategy. Having a culturally diverse team helps in the improvement of quality of patient care, increase in patient satisfaction, as well as increase in nurse and physician satisfaction (Ballard, 2003). Cultural diversity refers to having members from various cultures, races, and ethnicities (Ballard, 2003). Since Cedars-Sinai serves a Jewish majority, the team should learn of and integrate members of other races and ethnicities, as this will ensure the provision of patient-centered care to a diverse patient population. Cultural diversity could also ensure that the team members come up with decisions focusing on every patient’s culture and beliefs, thus supporting patient-centered, culturally competent care.

Leadership Theory

A leadership theory that would be helpful in developing a team responsible for the implementation of the strategy is transformational leadership. This style of leadership stresses the need for interpersonal relationships (Gomes, 2014). It could work well in the multidisciplinary team as the leader of the group will motivate members who will, in turn, inspire one another to come up with the best decisions as far as implementation of the strategy is concerned. Another aspect of transformational leadership is that it emphasizes merging desires, values, motives, and goals of the team to ensure a common cause is arrived at. The leadership style could prove pivotal in the need to involve patient/family in hospital committees and advisory councils and thus helping in the promotion of patient-centered care.

Implementation of Strategy

The multidisciplinary team will need to work together to identify what can be done to ensure the involvement of patient/family in hospital committees and advisory councils. A fundamental aspect will be the identification of existing groups without representation and ensuring that these groups are allowed to recruits members. As part of the team, the administrator will ensure the team adheres to regulations in coming up with decisions related to involving patient/family in hospital committees and advisory councils. The nurse representative will ensure that policies and procedures that hospital committees and advisory councils are to follow are developed. The project manager will also work hand in hand in ensuring that equipment and necessary resources are availed. The physician will give insight into care and getting information from other physicians regarding patient/family involvement in house committees and advisory councils. The representative of the patient/family will be tasked with giving input on experiences of being a patient or family and what needs ought to be satisfied during the implementation of the strategy.

Communication to Organization

The team will communicate the identified strategy and intended outcomes to the healthcare organization through one-hour drop-in sessions as well as scheduled sessions over a three-month period. The three-month period will help to ensure that the outcomes are well disseminated to many people. Physicians and nursing rounds will be part of the sessions. Moreover, community outreach events will be part of the sessions. The major target will be patient and family members although other members of the healthcare organization will be targeted as well. Every member of the multidisciplinary team will give his/her feedback regarding the new strategy and its effectiveness in the different sessions.

Tools for the Team

For self-assessment purposes, the team can rely on a tool referred as the DISC. This tool can help the team members to understand themselves well and ensure that they have common or similar behaviors to enable them to work perfectly together. DISC stands for dominance, influence, steadiness, and conscientiousness (Fallon, 2015). Dominance entails ability to emphasize on accomplishing results, accepting challenges, and getting straight to the point. Influence points to the ability to persuade others, openness, showing enthusiasm, being optimistic, and being ready to collaborate. Steadiness entails emphasis on cooperation, being calm, and exhibiting supportiveness. Conscientiousness entails enjoying independence, objective reasoning, wanting details, and fear for being on the wrong. With this assessment tool, the team members can recognize their personality and how well they can work with others of different personalities. The team can also rely on the tool to learn of the personality that would help to improve their working relationships.

 

Patient-centered care is becoming a priority for healthcare organizations. Business practices, regulatory requirements, and reimbursement can impact patient- and family-centered care. The focus of healthcare facilities should be on meeting the expectations of everyone, but most importantly the expectations of patient/family if they are committed to offering patient/family-centered care. As such, having the right team in place that will ensure that these perspectives are accomplished is crucial.

 

References

Ballard, R. (2003). The Implications of Cultural Diversity for Health Care Practice: An Anthropological Perspective. Retrieved from http://crossasia-repository.ub.uni-heidelberg.de/247/1/healthcare_1.pdf

Cedars-Sinai Medical Center. (n.d.). About Us. Retrieved from https://www.cedars-sinai.org/about.html

Fallon, N. (2015, December 30). DiSC Assessment: What Kind of Leader Are You? Retrieved from https://www.businessnewsdaily.com/8692-disc-assessment.html

Gomes, A. R. (2014). Transformational Leadership: Theory, Research, and Application to Sports. Retrieved from https://repositorium.sdum.uminho.pt/bitstream/1822/26921/4/2-Cap%C3%ADtulo-Lideran%C3%A7a%20transf%20no%20desporto-R%20Gomes-Contemporary%20Topics%20and%20Trends%20in%20the%20Psychology%20of%20Sports-Vers%C3%A3o%20da%20editora.pdf

Kritsonis, A. (2005). Comparison of Change Theories. International Journal of Scholarly Academic Intellectual Diversity8(1), 1-7. Retrieved from https://www.semanticscholar.org/paper/Comparison-of-Change-Theories-Kritsonis-Hills/d33852c85e084ecc756ea55a68fc735705349f34

Roussel, L. (2012). Management and leadership for nurse administrators. Burlington, MA: Jones & Bartlett Learning.

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