Purpose and OverviewNurse consultation involves the application of change management principles and visionary leadership to the improvement of healthcare organizations. Guided by evidence-based practice and ethical principles of the healthcare profession, nurse consultation is a process involving multilateral communications, quantitative assessments, goal-setting, and strategic change management. Advance practice nurses can collaborate with nurse leaders to identify problems, analyze those problems and their root causes, and identify meaningful and feasible methods of achieving desired changes and measurable outcomes.

The purpose of this consultation is to work with nurse leaders, administrators, and executives to help the local healthcare organization better meet their goals and improve patient satisfaction. Nurse consultation requires the use of multiple, rigorous empirical methods. The data collection processed used in this case include both qualitative methods like interviews and focus groups, as well as quantitative data gathered from HCAHPS scores, patient metrics, and patient surveys. Although the current consultation strategy does not require formal comparisons with local organizations, other area healthcare institutions can offer meaningful points of comparison when inspiring change. The data collection methods will tacitly refer to the community, its needs, and also the need for the organization to better embrace corporate social responsibility models in their operating strategies.

Description of Organization

Jackson Health System in Miami, which comprises six individual organizations including Jackson Memorial Hospital, is a cluster of healthcare institutions that include teaching hospital, children’s hospital, and a range of specialized care centers. A total of 9000 employees work in the Jackson Health System, including physicians, nurses, and administrators. As a health system, Jackson recognizes the value of integrating multiple healthcare domains under one rubric: both geographic and cultural. The unified health system at Jackson depends on a hierarchical bureaucracy, but one that does also provide significant autonomy to its individual organizations or brands like the Holtz Children's Hospital. Jackson’s organizational structure includes a Board of Directors and Senior Officers including Chief Compliance Officer, Chief Financial Officer, Chief Transition Officer, and Chief Nursing Officer. Corporate offices work alongside but separate from the healthcare officers, such as the Human Resources Officer, and the Corporate Directors of Public Safety and Public Relations.

Comprising as it does six different hospitals and twelve specialty care centers, as well as a system of clinics and pharmacies and several long-term treatment facilities within the parent structure, Jackson Health System offers a comprehensive range of medical products and services for a diverse metropolitan area. Jackson Health System offers specialized care that is unparalleled in the South Florida area, including trauma care, and also proudly proclaims itself to be the only hospital in the state to offer every type of organ transplant (Jackson Health System, 2018, “About Us”). Affiliations with a number of other health care institutions expands the role Jackson Health System plays in the community, providing community-based services and services for medical education and research. Jackson Health System is also a teaching hospital affiliated with the University of Miami Leonard M. Miller School of Medicine, which itself has 1000 full-time faculty members.

Primary Needs of Population

The Jackson...

Several of its hospitals and specialized care centers offer services that cannot be found elsewhere in the region or even in the state, making it a magnet institution too. Jackson Health System provides neonatal care, geriatric care, and everything in between. The diverse patient population within the immediate Miami-Dade County possibly includes almost three million individuals, more than two-thirds of which are Hispanic/Latino, and almost twenty percent of which are African American (United States Census, 2010).
According to a report by Miami-Dade County (n.d.), local identifiable risk factors are largely related to lifestyle including obesity-related diseases and diabetes. While teen obesity numbers have improved, adult obesity has actually increased (Miami-Dade County, 2011). In “Measuring What Matters,” a Miami-Dade County Community Health Report Card update, the county also identified other major concerns of the population that can be addressed via improvements to the healthcare system, including prenatal care deficiencies and problems related to low birth weight and infant mortality. Immunization numbers have also been on a decline, with resulting public health concerns (Miami-Dade County, 2011). Substance abuse and alcohol-related problems are also major issues of concern, as are high rates of sexually transmitted diseases. Rates of HIV/AIDS have also been increasing, and remain twice the Florida average (Miami-Dade County, 2011). Rates of cancer in the area have actually been decreasing, according to the Miami-Dade County (2011) report. As the largest and leading healthcare organization in Miami-Dade County, Jackson Health System is on the front lines of public health services and has a distinct role to play in improving county health outcomes.

Nurse Leader’s Role

This consultation depended on the help of a nurse leader within the Jackson Health System, the Vice President and Chief Quality Officer Kevin Andrews. Andrews worked as a nurse practitioner for several years within the Jackson system before shifting to a position of leadership within the organization. As Chief Quality Officer, Andrews considers himself a liaison between the community and the organization. Andrews pays close attention to performance metrics and outcomes and was chiefly responsible for suggesting the implementation of nursing consultation during the process of change management at Jackson. When asked about his formal position and influence within the Jackson Health System, Andrews focuses on the data-driven nature of his role. The Chief Quality Officer knows that health outcomes and patient metrics are linked to reimbursements and funding, as well as to the ethical obligations of the institution. Therefore, the Jackson Health System depends on Andrews and his team for remaining solvent and competitive. Informally, Andrews helps motivate other nurse leaders to implement procedural changes that will result in measurable performance and patient outcome improvements.

Characteristics of Organization

Current Strengths

Jackson Health System is entrenched in the community, has strategic affiliations with local specialty care facilities, and also functions as a teaching hospital. Therefore, Jackson’s core strength is its role in the community and within the healthcare sector in general. Several Jackson organizations, notably the Holtz Children’s Hospital, are ranked relatively high on nationwide rankings like the U.S. News & World Report 2017-2018 evaluation. In addition to the remarkable metrics from Holtz,…