Improving Nurse Patient Communication in Service Delivery

Organizational Leadership in a Health Care Setting

Current Practice Setting

Recent work environments among practicing nurses show that the domain of personnel lacks in collaboration with patient and family in the job descriptions and policies during the process of performance appraisal. The setting has not given the patient or family a chance to participate on interview teams, yet it is vital for the search committees to gather such information for efficiency and effectiveness to be achieved in the hospital. Orientations are done in the practice, and family or patients are not welcomed during the process of orienting new employees. The process is important for them to take part in because they will relay information vital to the new staff concerning the care they are accorded by other staff in the facility. The environment and design of the facility must include the family and or patient to participate fully in clinical design projects because they are geared towards improving their stay in the hospital. The care they are accorded should be at par with the mission and vision of the organization that upholds the well-being of patients and their families. Charting and documentation lacks in the facility and this is a major problem because patient or family are not able to chart the results of the service the hospital gives them. Care support is also not high in the facility yet it is important to have the family being allowed to be present during rescue events as the support helps the practitioners give the patient the needed care.

The changes adopted have always prioritized on satisfying the patients' needs. It is the work of both nurses and health care organizations to give focus to the safety of patients and quality of care accorded to their clients and always ask the question, "What is best for the patients?" As such, health care has managed to move from a favored to a less favored employment sector. The drivers of such significant change are attributed to the economic constraints that result from changes in reimbursement for care, rapid advances in clinical technologies and modalities of care, and corporatism of health care systems.

The challenges exacerbating to the nurses work environment for their practice is attributed to the nationwide shortage of nurses and other allied professionals of the health fraternity. The insufficient numbers of nurses is a problem resulting from multiple factors of supply, demand and the aging workforce that continue to contribute to the problem to care for the rising needs of the American population. The actual supply of nurses continues to grow in America, but this has not kept up with a significant increase in nurses' demand. The practice has a non-centered experience where patients confuse medications; patients take it upon themselves to convey medical information from their specialist to surgeons, discharge procedures have resulted in readmissions and even patients not knowing the best provider to follow. All these are repercussions that stem from poor communication and care coordination that is extensive because it affects patient satisfaction, quality and safety of care and the financial and operational aspects.

A2: how patient- and family-centered the evaluated organization is

The patient-and-family-centered will work best for the organization because the efforts of the hospital leaders are to improve health care quality and safety. Leaders have realized the importance of including a perspective that has been missing for too long from the health care equation: the perspective of patients and families. The care experience perceived by patients and family members is a critical factor in health care safety and quality. Therefore, they are looking to bringing the perspectives of patients and families directly into their planning, evaluation, and delivery of health care. Eventually, they improve the quality and safety of their patients, which is the highest of worries among patients and their families. Health care administrators, providers, patients, and families need to work together in partnership to improve their quality and safety of healthcare, decrease costs and increase on provider and patient satisfaction.

As such, the core concepts that will need to be investigated are information sharing, participation, and collaboration. Knowledge, beliefs, values and cultural backgrounds of their patient and family need to be incorporated into the planning and care delivery aspects. Sharing of information looks at having complete and unbiased information shared with patients and families in affirming and useful ways (Stange et al., 2010). Therefore, patient and family will receive information that is accurate, timely and complete and this enables them to participate effectively in care and decision-making processes. The aspect of participation involves having patient and family encouraged and supported in their participation in care and decision-making at their level of choice. Lastly, collaboration appreciates the efforts of the families, patients, health care practitioners and health care leaders collaborate in the development, implementation and evaluation of policy and program. Moreover, they work in facility design and professional education plus the delivery of care.

A3: Gaps for Improvement

At XYZ Medicare, the organization is seen to have gaps that are inclined to making a thoughtful assessment of the degree to which the hospital has already incorporated the key principles of the approach to care and mention the areas where progress remains to be made. Establishing patient -- and family-centered care is a long-term commitment and entails the transformation of the organization's culture. The approach in question is a journey that requires continual exploration and evaluation of new ways that collaborate with the needs of patients and families. One of the most important recommendations in closing the existing gap in the hospital is in creating improved safety systems inside the hospital through the implementation of safe practices particularly in the delivery level, which also includes interdisciplinary clinical practices among the health professionals. The interdisciplinary training or collaboration is a joint decision making and communication process among the health care providers. The goal of such a move is in satisfying the needs of their patients and at the same time respecting unique abilities of their professionals involved in the health care. As such, the attributes of this collaboration are knowledge, trust, good communication, coordination, mutual respect, cooperation, optimism and shared responsibility.

The organization should consider having education programs for the facility, and this will require curricula that give support to interdisciplinary practice in a variety of its settings. The programs in question should give emphasis to conflict resolution, teamwork and informatics use that promote collaboration in patient care planning and implementation. The era in question concerns workforce shortages and the expanding need is to have high-quality professional nursing care due to the changes in population socio-demographics and the health care system. As such, the need that is critical is in fully utilizing the skills and knowledge of professional nurses and thus, ensure retention practices in the profession and attraction increases the number of individuals into the nursing discipline (Stange et al., 2010).

B: How Business Practices and Regulatory Requirements Impact Patient- And Family-Centered Healthcare

According to Charmel and Frampton (2008), the business practices and regulatory requirements of patient -- and family-centered healthcare have the potential to reduce adverse events, operating costs, malpractice claims while improving market share. Therefore, the design modeled by the organization treats, comforts, engages and empowers patients. As such, solidification of the approach was a way of creating an experience that was more appealing to the patients and is a fundamental practice for the provision of high-quality care. Therefore, having such business practices in the facility will mean that costs are reduced, and all shareholders will adhere to regulatory requirements of the facility. By engaging patients and families care experiences, cost-effectiveness, and clinical metrics are improved. By using health information technology appropriately, this catalyzes the needed changes. Having excellent medical care is a combination of sophistication in scientific knowledge with communication skills that understand the needs of individual patients in addressing their feelings and concerns with compassion and sensitivity. Furthermore, patients need to be educated about their choices of care for the benefit of good communication in the care of patients and outcomes are unequivocal (Levinson & Pizzo, 2011).

C: A Strategy that Includes Goals and an Operational Plan to Increase Patient-Centeredness

In achieving the potential for patient-centeredness, it is vital for the patient to become an integral part of three core functions of the organization: 1) policies and governance; 2) quality improvement activities; and 3) individual patient clinical interactions. For the workforce strategy, the hospital needs strength for the patient-centered and coordinated care to be successful. As such, it will need to reward its employees and appreciate their efforts in a manner that shows how much the leaders value their work. The first step will involve devoting the governance of the hospital structures to the experience of patients. Therefore, the hospital will need to use patient and family advisory councils because they are a sound indication of the commitment to the hospital to achieving patient-centered care. The second step will involve "patient champions" throughout the workforce of the hospital where formal roles are being created within the hospital and its system to give focus on patient-centeredness.

C1: Discuss financial implications that this strategy may have on the organization.

The financial implications of the strategy will be diverse on the resources of the company, but they are long-term goals. The training of the workforce will mean that the resources used will come from the capital set aside, and therefore, this might strain the organization. Thereby, employers will be forced to sacrifice their allowances to enable for the smooth running of activities in the organization.

C2: Potential members for a multidisciplinary team who could assist you in improving the identified gap.

Patient navigators will act as "quarterbacks" who will oversee the coordination of patient care from the time of admission to discharge to follow-up. The other potential members for XYZ will include a doctor, allied health professionals such as a dietitian and social worker, and the local community care workers will come in handy. These primary caregivers are essential for XYZ Medicare in promoting and restoring the health and well-being of their patients. We shall also have case managers and other healthcare professionals who have particular expertise in symptom management of patient's cases (Small, & Small, R., 2011).

C2a: Discuss the purpose and scope of the team, including team member roles.

Having such individuals in the organization makes the healthcare more patient-friendly and accessible and thus, eliminates any existing barriers of interferences that hurt the care of patients. The hospital can also establish departments that oversee initiatives such as patient advisory that serves as a liaison between patients and the hospital. The multidisciplinary teams are primary health care teams and therefore, they will communicate with each other about the patient's care. Moreover, the team will help the patient and family get the care from other team members when they need it. These professionals will come from a range of organizations and will work in the Medicare facility plus other care settings. From each discipline-specific team member, they enrich the knowledge base of the multidisciplinary team and over time, the composition of the team changes to reflect changes in the needs of patients (Levinson & Pizzo, 2011).

The roles of the team members will be to maintain regular contact with patients and initiate an effective and timely response when their needs change. Furthermore, the team members will liaise with other team members and service providers to enable them to organize regular case conferences and team meetings to review the cases they are handling. When it comes to the case manager, his/her role is to provide general household assistance, care and companionship to the patient when a family member is resting or freshening up and for emotional support. They also help patients' access health services available in their community. The dietitian will provide nutritional and dietary advice while social workers provide counseling services to the patients. They give psychological and emotional aspects of living with their present condition, and they can provide vital information on services available in the patient's community. The services may be helpful to the patient with their legal, accommodation, and financial issues among other issues (Small, & Small, R., 2011).

C2b: The Importance of Diversity within the Team to Support Patient-Centered Care

Diversity within the team of healthcare providers is in the attempt of eliminating racial or ethnic disparities in the healthcare. As such, diversity will improve the quality of health care services and thus, it increases health equity and reduces disparities among patients by concentrating on people of color and other populations who are disadvantaged. Diversity is an aspect that should be emphasized in the facility because it is a set of skills for nurses and other shareholders of XYZ Medicare. Thereby, through diversity the facility renders effective patient-centered care.