Assessing patient-centered care readiness at Golden Kenneth Healthcare

Organizational Leadership and Team Development

Organizational Leadership & Inter-professional Team Development

In a contemporary healthcare environments, application of a quality healthcare is a complex system because it encompasses unique regulatory requirements, economic process as well as quality indicators that cannot be found in the traditional business environment. In essence, it is very critical to develop unique skill sets to the development of inter-professional team development and organizational leaderships that are critical for healthcare leaders at all level. Moreover, understanding the comprehensive approach to the patient care management is essential given the complexity that occur with the healthcare industry. The concept of organizational leadership assists in creating a team development to support leaders in order to create an effective patient-centric environment. (Weng, Kuo, Yan, et al. 2013).

The self-assessment tool is the strategy to understand the breadth and elements of family and patient care that assists organization to create an effective patient-centric environment. The tool assists an organization to assess or evaluate its performances in relation to the family and patients components. In essence, the self-assessment tool assists healthcare providers to understand a broad range of family and patient care. The tool assists in comparing the current practice of an organization with the leading edge of an health practice. (Thomas, Saroyan, Dauphinee 2011).

Objective of this project is to use the self -assessment tool to evaluate the current health practice of Golden Kenneth Health Care (a fictional name). The organization has been operating for more than 50 years and has delivered a quality healthcare for patients and family across the United States. However, constant demand for quality care by the stakeholders and the regulatory environment makes the organization to assess itself in order to identify the functional practices that require improvement.

A: Complete Assessment Tool

The researcher fills in the PFCC (Patient- and Family-Centered Care) tool to assess the Golden Kenneth Healthcare readiness in improving family and patients needs. The appendix 1 provides the results of the PFCC for the Golden Kenneth Healthcare.

1.Current Practice Setting of Golden Kenneth

Evidence-based practice incorporates patient's values, scientific-based evidence and clinical experience to implement professional patients' care. The current practice setting of the Golden Kenneth shows that the organization is dedicated in promoting and advance the health of patients and families. The organization has been able to achieve its health objectives through mutual interaction with patients and family. By using the inspirational leadership style, the organization has been able to improve patients clinical problems from patient's perspectives. Golden Kenneth has also focused in searching for solutions to the problems through education of employee to improve patients and family experience.

Based on the strategy that the organization employs in carrying out its operations, Golden Kenneth has been able to put patients first using network of care facilities. Over the years, Golden Kenneth has recorded the visits of more than 30 million annual outpatients, and over 5 million annual hospital admissions. The organization also has more than 100,000 healthcare professionals. Thus, the Golden Kenneth has been able to improve the quality of patients' health through the implementation of effective information resources. (Weng, Kuo, Yan, et al. 2013).

Moreover, the hospital has taken an effective quality implementation into high consideration using qualified and experienced healthcare professionals. Over the years, the hospital is able to meet the health needs of family and patients using the holistic healthcare supports. Despite the effectiveness of the hospital in enhancing heath outcomes of patients and families, the organization is stiff facing challenges in activating a rapid response to support healthcare of patient and families. The study provides the analysis of the method the Golden Kenneth Health Care centers its policies on the family and patients in order to contribute to their health outcomes.

3: Gaps where the Hospital Could Improves its Family and Patients Centeredness

Despite the excellent scores that the Golden Kenneth Healthcare records from the results of the PFCC and PF tool, however, there are still some health elements where the Golden Kenneth needs to improve its family and patients centeredness. Golden Kenneth Healthcare scores 3 out 5 with regards to the ability of the organization to deliver information to the family and patients through the web portal. In a contemporary healthcare environment, face-to-face tradition communication has been the foundation of patients-physicians relationships, however, electronic communication using the web portal is increasingly important in delivering quality healthcare system. Typically, web portal assists organization to implement online medical advice, online group supports, home monitoring systems as well as enhancing personal health records. Golden Kenneth should improve on the Web Portal platform to improve the organizational to deliver specific resources to family and patients. We live in the age where accurate and timely information is very important. In essence, patients and family desire vast and comprehensive information about surgery before allowing a surgeon to carry out the operation. Typically, information acquired through books, magazines, and other traditional information sources may not provide adequate information that patients may require about their health outcomes. (Autores, 2012). Thus, electronic communication through the web portal will facilitate an accurate and timely information sharing among patients, families and healthcare professionals.

Moreover, Golden Kenneth Healthcare performs below average in some elements in care support. For example, the organization does not provides effective facilities where "Families can stay, join in rounds and change of shift report" ( Institute for Family-Centered, 2010 P. 1). because the Golden Kenneth score 2 in this element. The organization also scores below average scoring 2 out 5 in its ability to provide family and patients the rapid response systems. Overall, the organization 3.33 out 5 in the care support system. However, the Golden Kenneth performs excellently in the domain of care based on its score for the assessment tool because the overall scores of the organization is 4.25 out of 5. Golden Kenneth also needs to improve on charting and documentation based on the average scores recorded. Typically, Golden Kenneth needs to improve on its ability to enhance a charting experience for family and patients .

Method to employ in Enhancing Improvements

Golden Kenneth is required to improve on web portal in order to enhance a communication system between family, patients ad portal. Typically, the organization is required to redesign its web portal to facilitate easy access of patients and family into the web portal in order facilitate effective communication. For example, Golden Kenneth Healthcare should integrate a chat platform in the web portal where family and patients will able to communicate with physician and other healthcare providers real time . An effective application of family and patient centered care requires a transparent and open information sharing to eliminate the occurrence of medical errors.( Glasziou, Ogrinc, Goodman, 2011).

Moreover, Golden Kenneth should improve on the facilities where family can stay, and change during the shift period. The organization should provide a large and conducive indoor facility where families can stay during the shift period. The facility should consist of waiting and resting rooms for families in case they may decide to have a short nap. The strategy will increase the number of families staying with patients during the shift periods.

More importantly, Golden Kenneth should improve on the strategy families and patients activate a rapid response system. The strategy is to provide an elaborate orientation and training for employee to assist family and patients to activate rapid response system. The orientation should include the organizational expectation to support patients and families.

B: Analysis of the Impact of Regulatory and Business Practices on Family and Patient- Centered healthcare

The concept patient-centered care is a self-evident health care program that address the need of patients and family. However, there are still some issues that can affect a successful implementation of the program. For example, Golden Kenneth may violate the HIPAA ("Health Insurance Portability and Accountability Act") (America Medical Association, 2014 p 1) by inviting the patients to read their medical charts. Thus, the organization may be unwilling to share medical records with patients.

However, the organization can still optimize an opportunity by providing communication and education to patients by allowing patients to read their charts. The strategy will assist an healthcare provider to ask questions about the patient's lifestyle. The hospital should allow the patients to read their chart privately. However, the organization should make the patient to sign a form before releasing the medical information for the patients.

Another impact to the successful implementation of the program is the costs. A successful implementation of the changes to meet the needs of family and patients may make the Golden Kenneth in incurring high costs. Introducing changes will involves incurring high costs for the organization, which will affect other top programs within the organization. Based on the results of assessment tools, the organization is required to provide additional waiting and resting rooms for the families to make them staying in the hospital during patients' treatment. Another impact of family and patient centered on Golden Kenneth is that the organization will require to increase its staffing ratio to assist patients and family activating a rapid response.

Despite the impact identified in successful implementation of the patient family centered program, healthcare organizations still require complying with the federal and state regulations. The United States has put in place regulatory frameworks to assist an implementation of family and patient centered healthcare system. For example, the Joint Commission provides information on patients' needs as well as providing guidance for organization to work towards the needs of patients. Part of the Joint Commission requirements is to facilitate an effective communication for patients and families . The Commission views an effective communication as well as patient centered care as affective components for safe and quality care. Part of the requirements of Joint Commission is that an healthcare organization should inform patients their rights upon admitting them into the hospital.

Apart from the Joint Commission requirement, the U.S. offers different rules and regulations that healthcare providers should observe when dealing with patients. For example, federal civil laws provide requirements that hospital should follow when dealing with patients having LEP (limited language proficiency) such as hard hearing individuals or deaf or people having problem in understanding the English language. Thus, Golden Kenneth Healthcare is required to aware these laws.

Typically, hospitals are required to meet patients needs in order to comply with the regulations laid down by the United States. For example, "Section 504 of the Rehabilitation Act of 1973" (America Medical Association, 2014 P. 1) reveals that healthcare organization should provide modern health facilities for patients with physical disability.

Hill-Burton Act also authorizes the health care organizations to renovate their medical facilities to meet the needs of patients. Healthcare organizations are required to comply with Federal Civil Rights to participate in the Medicare program. Essentially, there is a general misconception that application of Centered Healthcare will require high costs of implementation, nevertheless, the operational benefits of the program are higher than the costs incurred. A comparison of two hospital units of the same types of supply costs, organizational pay rates, skill mix, patients and regulatory compliance program shows that an healthcare organization applying patients family centered model achieves more operational benefits than the organization that is not integrating the family centered model in its operations.

C: Strategy, Goals and Operational Plan

One of the strategies that Golden Kenneth can employ to improve the patient centeredness is to implement a cultural transformation within the organization. Typically, the organization should articulate a core value of patient centeredness in the organization culture. Moreover, the hospital leaders must demonstrate a full support for the program because without the support of the leaders, it may be challenging to implement changes to embrace a concept of patient centeredness within the organization. Moreover, the organization should collaborate with family and patient advisers to incorporate the patient centeredness in the organizational value, mission, and philosophy. Golden Kenneth should also create a paid family and patient leader position who will be responsible to coordinate, oversee and implement the program across the organization. (Clark, and Taplin, 2012).

Moreover, Golden Kenneth should build a low-tech Bulletin-Board program that will facilitate communication between patient, family and healthcare professionals. The organization should ensure that each department assigns an employee who will be in charge of posting the relevant information on the bulletin board.

C1:Financial Implications of the Strategy on the Organization

The financial implications of the strategy for the Golden Kenneth are as follows:

First the organization will derive financial benefits from implementing the strategy because patients will understand that Golden Kenneth is taking their health interests into consideration thereby increase the number of patients that will patronize the hospitals. More financial outcome of the strategy is that the organization will be able to increase its annual revenue with increase in the number of patients patronizing the hospital. Autores, 2012).

2. Identification of Potential Members for the Multidisciplinary Team

The potential for the multidisciplinary team should include

Physician

Board engagement

Volunteer engagement

Families and Patients engagement

2a.Purpose, Role and scope of the team

Glennister, (2013) uses the systemic theoretical framework how an organization perform. The system theory argues that a healthcare provider should interact with patients both as open system and human being to achieve a common goal. Thus, nurses should combine administrative, clinical and financial variables to achieve patient health outcomes. (Glennister, 2013).Thus, a support of a physician to the patient-centered will assist in enhancing organizational values. Typically, physicians participation will facilitate a communication forum between patients and healthcare professionals. Moreover, engagement of a member of board in the patient centered will facilitate sustainable development of the program. A volunteer member will contribute their talents to the effectiveness of patient-centered through meetings, invitation and newsletter. Participation of families and patients in the team will assist the organization to understand the better way to facilitate the needs of patients and families The organization should include member for of different age group, and ethnical origin to ensure that different groups from different origin are represented.

2b. Importance of Diversity

Integration of diversity within the healthcare setting is very critical for the organizational effectiveness. Organizations that allow different ethnic groups in the team of the patient centeredness will facilitate effective application of the program because all people from different background will be represented. Moreover, people from different settings will be able to provide a positive input that will enhance effectiveness of the program.

2c. Golden Kenneth Health should use feedback from patient and families and other team member to evaluate the effectiveness of the program. The outcome of the feedback will make the organization to understand the performances of the team member. Typically, the organization can use tools such as survey, and personal interview to understand the needs of the team. Moreover, the organization should provide an occasional financial contribution to the team for their time and contributions towards patients centeredness.

Reference

America Medical Association, (2014). HIPAA Violations and Enforcement. USA.

Autores, V. (2012). Pediatric Surgery. Elsevier Health Sciences.

Clark, H. And Taplin, D. (2012) Theory of Change Basics: A Primer on Theory of Change. New York: Actknowledge

Glennister, D. (2013). Towards a General System Theory of Nursing: A literature Review. University of Hull, Hull, UK

Glasziou P, Ogrinc G, Goodman S. (2011). Can evidence-based medicine and clinical quality improvement learn from each other? BMJ Qual Saf, 20:i13-17.

Institute for Family-Centered (2010). Patient- and Family-Centered Care Organizational Self-Assessment Tool. USA.

Jackson, E. (2013) Interrogating the theory of change: evaluating impact investing where it matters most. Journal of Sustainable Finance & Investment, 3:2, 95-110.

Stone, S. (2008). "A Retrospective Evaluation of the Impact of the Planetree Patient Centered Model of Care Program on Inpatient Quality Outcomes." Health Environments Research and Design Journal, 1(4):55-69.

Thomas A, Saroyan A, Dauphinee W.D. (2011). Evidence-based practice: a review of theoretical assumptions and effectiveness of teaching and assessment interventions in health professions. Adv Health Sci Educ Theory Pract, 16:253-276.

Weng, Y. Kuo, K.N. Yan, C. et al. (2013). Implementation of evidence-based practice across medical, nursing, pharmacological and allied healthcare professionals: a questionnaire survey in nationwide hospital settings. Implementation Science, 8:112

Appendices

Appendix 1

Domain

Element

Low High

Do not know

Leadership / Operations

"Clear statement of commitment to PFCC and PF partnerships"

1

2

3

(4)

5

"Explicit expectation, accountability, measurement of PFCC"

1

2

3

(4)

5

"PF inclusion in policy, procedure, program, guideline development, Governing Board activities"

1

2

3

(4)

5

Mission, Vision, Values

"PFCC included in mission, vision, and/or core values"

1

2

3

4

(5)

"PF-friendly Patient Bill of Rights and Responsibilities"

1

2

3

4

(5)

Advisors

"PF serve on hospital committees"

1

2

3

(4)

5

"PF participate in quality and safety rounds"

1

2

3

(4)

5

"Patient and family advisory councils"

1

2

3

(4)

5

Quality Improvement

"PF voice informs strategic/operational aims/goals"

1

2

3

(4)

5

"PF active participants on task forces, QI teams"

1

2

3

4

(5)

"PF interviewed as part of walk-rounds"

1

2

3

(4)

5

"PF participate in quality, safety, and risk meetings"

1

2

3

(4)

5

"PF part of team attending IHI, NPSF, and other meetings"

1

2

3

(4)

5

Personnel

"Expectation for collaboration with PF in job descriptions and PAS

1

2

3

(4)

5

PF participate on interview teams, search committees

1

2

3

(4)

5

PF welcome new staff at new employee orientation

1

2

3

(4)

5

Staff/physicians prepared for and supported in PFCC practice"

1

2

3

4

(5)

Environment and Design

"PF participate fully in all clinical design projects"

1

2

3

4

(5)

"Environment supports patient and family presence and participation as well as interdisciplinary collaboration"

1

2

3

(4)

5

Domain

Element

Low High

Do not know

Information / Education

"Web portals provide specific resources for PF"

1

2

(3)

4

5

"Clinician email access from PF is encouraged and safe"

1

2

3

(4)

5

"PF serve as educators/faculty for clinicians and other staff"

1

2

3

(4)

5

"PF access to/encouraged to use resource rooms"

1

2

3

(4)

5

Diversity and Disparities

"Careful collection and measurement by race, ethnicity, language"

1

2

3

(4)

5

"PF provided timely access to interpreter services"

1

2

3

(4)

5

"Navigator programs for minority and underserved patients"

1

2

3

(4)

5

"Educational materials at appropriate literacy levels"

1

2

3

(4)

5

Charting and Documentation

"PF have full and easy access to paper/electronic record"

1

2

3

(4)

5

"Patient and family are able to chart"

1

2

(3)

4

5

Care Support

"Families members of care team, not visitors, with 24/7 access"

1

2

3

(4)

5

"Families can stay, join in rounds and change of shift report"

1

(2)

3

4

5

"PF find support, disclosure, apology with error and harm"

1

2

3

(4)

5

"Family presence allowed/supported during rescue events"

1

2

3

(4)

5

"PF are able to activate rapid response systems"

1

2

3

(4)

5

"Patients receive updated medication history at each visit"

1

(2)

3

4

5

Care

"PF engage with clinicians in collaborative goal setting"

1

2

3

(4)

5

"PF listened to, respected, treated as partners in care"

1

2

3

(4)

5

"Actively involve families in care planning and transitions"

1

2

3

(4)

5

"Pain is respectively managed in partnership with patient and family" ( Institute for Family-Centered, 2010 P. 1).

1

2

3

4

(5)