Organizational Systems and Quality Leadership

Organizational Systems and Quality Leadership

Organizational Systems & Quality Leadership

J. is a hospital patient who is Jewish and has mild dementia. He has an injury to his hip, and the goal is to make sure he heals correctly. However, there are some concerns with nursing-sensitive indicators that are taking place regarding his care. Understanding these better could assist the nurses in identifying the issues he is having and that could interfere with his care. Addressing concerns that come to light is part of good leadership (Forsyth, 2009; Hackman & Johnson, 2009). Without the proper level of leadership, individuals in medical and other settings are not going to provide true quality to clients -- who are, in this case, patients. For Mr. J., the biggest concern is the lack of transparency in his treatment, along with the nursing-sensitive indicators that are noted in his case. These are the use of restraints and the pressure sore he has developed, along with the difficulties ensuring that he is receiving proper nutrition and a completely kosher diet. Since there are not that many Jewish patients, ensuring kosher meals for those who are Jewish has been lax, at best.

Leaders in a hospital setting must be very careful when it comes to proper treatment of patients, because they can be held liable for issues the nurses or other staff members may cause. The problem with Mr. J.'s food was kept quiet until one of the dietary staff mentioned that he received a non-kosher meal (a pork cutlet) the night before. His daughter should have been informed of that when it took place, but this was not done. That may seem like a small incident, but over the previous six months there had been several complaints regarding non-kosher meals being given to Jewish patients. Additionally, Mr. J.'s daughter questioned the pressure sore and the restraints, but her concerns were not taken seriously and she was told it was nothing and not to worry about it. This does not indicate proper leadership and training.

It is very important to consider hospital data on nursing-sensitive indicators such as pressure sores and restraint prevalence, so patient care can be improved. While some pressure sores are hard to avoid, especially in elder patients who must remain immobile for some time and/or who must be careful about which positions they can lie in to protect a damaged area of their body such as a hip, most pressure sores can be avoided. Additionally, the use of restraints may not be needed in someone with mild dementia, and no mention is made of whether Mr. J. was attempting to get up and move around before the restraints were used. It appears as though the nurses were not focused on true quality of care where the pressure sore is concerned, and that they took the easiest option with the restraints before they determined whether Mr. J. would actually require them. This is not successful nursing with a patient-centered approach. As a leader in the hospital, one would want to adjust some of the ways patients are being treated, to provide them with better care.

Leaders should be clearly focused on what their employees are doing and whether the client is receiving the best experience in interacting with the company (Scouller, 2011). This is true of any setting, including medical care. When leaders are taking good care of their clients and training their employees to do the same, much more can be accomplished and the experience is better for everyone involved (Lussier & Achua, 2010). Not everyone thinks of a hospital as a business, but it must be operated as such if it is to take proper care of patients and make enough profit to continue to function. One of the best ways in which to be successful in those endeavors is to have good leadership. Proper leadership allows for an overall experience that is the best for everyone involved (van Vugt & Ahuja, 2011). In a medical setting, the leader must be sure to pass important knowledge and information down to those who are caring for the patients, and must take action to correct known problems.

There are resources that can be used to ensure patients are receiving the best care possible. As a nursing shift supervisor, working with the right colleagues and using the proper resources could help the patient and also resolve the ethical issues that are seen in Mr. J.'s case. Any leader who wants to see success for all involved in any business endeavor must be open to working with a number of people who can provide what is needed in the overall equation (Schultz & Schultz, 2010). In the case of Mr. J., a nursing shift supervisor would have three issues with which to deal -- the pressure sore, the restraints, and the non-kosher meal the patient was served on the previous night. With regard to that meal, there are sub-issues regarding the fact that he received the meal at all, the fact that this was not the first time this had been an issue, and that fact that his daughter was not told about the incident when it occurred and found out in an accidental way. Working with the food service staff to emphasize the importance of a kosher diet for Jewish patients and implementing significant penalties for providing a non-kosher meal may be necessary.