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Discussion-ACHE leadership competencies

Discussion-ACHE leadership competencies

Respond to at least two of your colleagues’ postings and continue the Discussion through Day 7. Expand on this Discussion by providing additional insights or alternative perspectives.

Discussion-ACHE leadership competencies

Peer posts 1

Jacquelyne Atakora 

Wk 4 Discussion

Meeting ACHE leadership competencies means having strategic management skills, which “involves building and allocating resources both to meet the needs of today and to fulfill the vision of the future” (Walston, 2018). Out of the five competencies, I have exceptional professionalism and communication skills that I have gained from overall work experience. Communication and relationship management mainly comes from having suitable customer service skills and knowing how to build appropriate, internal relationships for the betterment of the organization. Areas of weakness include “knowledge of the health care environment” and “business skills and knowledge”, which is based off of not gaining experience in these areas. I have no experience working in a health care, so I would need to get my foot in the door in that field. In order for any leader to effectively improve their weaknesses, they must be able to support change to encompass “encouraging individual growth and learning as well as organizational innovation” (Potthoff, 2004). Individual growth for me would mean building on my communication and relationship building skills to gain knowledge in health care and business. Networking, internships, and entry level positions are all ways in which I can gain proper knowledge to become a better leader. Speaking to the right individuals and getting my foot in the door at a proper business will help me put my strengths to use and continue to gain the knowledge I need to succeed.

Reference:

American College of Healthcare Executives. (2019). ACHE healthcare executive 2019 competencies assessment tool. Retrieved from https://www.ache.org/-/media/ache/career-resource-center/competencies_booklet.pdf

Potthoff, S. (2004). Leadership, measurement, and change in improving quality in healthcare. Frontiers Of Health Services Management, 20(3), 37–40.

Walston, S. L. (2018). Strategic healthcare management: Planning and execution (2nd ed.). Chicago, IL: Health Administration.

 

Peer Posts 2

Cornel Bedward 

Week 4 Discussion

When it comes to the ACHE leadership competencies building on the strengths and improving weaknesses is important to excel as a health care administrator and be successful. When it comes to communication and relationship management it is extremely important to execute this properly. Furthermore, leadership is essential with managing change and communicating the organizations mission and vision. Also, professionalism is a competency domain that meets up with the other domains. Continued education and planning is important to ensure that the role of the individual is being met for the benefit of the organization. Additionally, employees should have a good understanding of the health care environment. Unfortunately, this requires internal and external management constraints that the staff really only understand. If new employees do not understand the flow of the organization, it will be hard for them to grasp the routine and create issues. So ensuring that new employees are educated and understand the vision and mission of the organization is essential for the success of the employees and the organization.

Reference

American College of Healthcare Executives. (2016). ACHE healthcare executive 2016 competencies assessment tool. Retrieved from, https://www.ache.org/pdf/nonsecure/careers/competencies_booklet.pdf

 

SAMPLE ANSWER

PEER RESPONSES

Jacquelyne Atakora 

Hi Jacquelyne,

I enjoyed reading your post. It is good that you seem to have realized your strength and weaknesses. A good leader should try to know his or her weaknesses as much as knowing the strengths. Weaknesses can hold someone back and prevent them from achieving their dreams. However, when one realized and acknowledges the weaknesses, they will work on improving them. As Geil Browning notes, “to truly be a great leader, you can’t just take advantage of your strengths. You also have to recognize your weaknesses, and learn how to make them benefit your particular leadership style” (Browning, 2017). A leader should understand well their area of work and therefore, understanding the healthcare system is very important for you in order to become a leader in the sector. In addition, having skills and knowledge related to the healthcare field is important for one to lead others in a healthcare system. The willingness you have to improve in the areas is the first step that is required to achieve your goals.

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Reference

Browning, G. (2017). Excel at What Does Not Come Naturally: 7 Ways to Lead Better. Retrieved from https://www.inc.com/geil-browning/leadership-managing-identify-your-weaknesses-and-lead-effectively-because-of-them.html

 

Cornel Bedward 

Hi Cornel,

You brought our good insights in your discussion. One thing that I can agree with you is that continued education and planning is important especially in the healthcare setting. Continuing professional development is important because it ensures you continue to be competent in your profession. It is an ongoing process and continues throughout a professional’s career. Continuous professional development ensures that one stays relevant and up to date (Prince & Reichert, 2017). Thus, one is more aware of the changing trends and directions in the profession. There are many changes happening in the healthcare sector especially in terms of technology. Thus, if one stands still, they risk being left behind, as the knowledge and skills they have become outdated.

Discussion-ACHE leadership competencies

Reference

Prince, S. & Reichert, C. (2017). The Importance of Continuing ProfessionalDevelopment to Career Satisfaction and Patient Care:Meeting the Needs of Novice to Mid- to Late-CareerNurses throughout Their Career Span. Retrieved from https://res.mdpi.com/d_attachment/admsci/admsci-07-00017/article_deploy/admsci-07-00017.pdf

 

 

 

 

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Statistical Analysis Assignment 08

Statistical Analysis Assignment 08

1. In the following situations, indicate whether you’d use the normal distribution, the t distribution, or neither.

a. The population is normally distributed, and you know the population standard deviation.b. You don’t know the population standard deviation, and the sample size is 35.c. The sample size is 22, and the population is normally distributed.d. The sample size is 12, and the population is not normally distributed.e. The sample size is 45, and you know the population standard deviation.

Statistical Analysis Assignment 08

2. The prices of used books at a large college bookstore are normally distributed. If a sample of 23 used books from this store has a mean price of $27.50 with a standard deviation of $6.75, use Table 10.1 in your textbook to calculate the following for a 95% confidence level about the population mean. Be sure to show your work.

a. Degrees of freedomb. The critical value of tc. The margin of errord. The confidence interval for a 95% confidence level

3. Statistics students at a state college compiled the following two-way table from a sample of randomly selected students at their college:

 Play chess

Don’t play chess

Male students

25

162

Female students

19

148

Answer the following questions about the table. Be sure to show any calculations.

a. How many students in total were surveyed?b. How many of the students surveyed play chess? c. What question about the population of students at the state college would this table attempt to answer?d. State Hº  and Hª for the test related to this table.

4. Answer the following questions about an ANOVA analysis involving three samples.

a. In this ANOVA analysis, what are we trying to determine about the three populations they’re taken from?b. State the null and alternate hypotheses for a three-sample ANOVA analysis. c. What sample statistics must be known to conduct an ANOVA analysis?d. In an ANOVA test, what does an F test statistic lower than its critical value tell us about the three populations we’re examining?

 

SAMPLE ANSWER

  1. In the following situations, indicate whether you’d use the normal distribution, the distribution, or neither.

 

  1. The population is normally distributed, and you know the population standard deviation.

 

Since the population is normally distributed and we know the population standard deviation it is a normal distribution (z-distribution).

  1. You don’t know the population standard deviation, and the sample size is 35.

 

We don’t know the population standard deviation, but we know the sample size is 35 we will do a normal, t-distribution.

  1. The sample size is 22, and the population is normally distributed.

 

With a normal distribution and a sample size of 22 we will do a normal, t-distribution.

Statistical Analysis Assignment 08

  1. The sample size is 12, and the population is not normally distributed.

 

Since the population isn’t normal and the sample size is 12 we will do neither distributions.

  1. The sample size is 45, and you know the population standard deviation.

Knowing the population standard deviation and the sample size we will do a normal distribution, (z-distribution).

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  1. The prices of used books at a large college bookstore are normally distributed. If a sample of 23 used books from this store has a mean price of $27.50 with a standard deviation of $6.75, use Table 10.1 in your textbook to calculate the following for a 95% confidence level about the population mean. Be sure to show your work.

Given:

 

Sample size: n :23

Sample mean: ̅x : $27.50

Sample Standard deviation: ơ: $6.75

95% Confidence Level

Level of Significance = α = 1-95 = 0.05

 Nursing Paper Help

  1. Degrees of freedom,

 

df: n-1 = 23-1 = 22 Degrees of freedom

  1. The critical value of t: 1-α/2,

df = 1-0.05/2, 22 = 0.975, 23 = 2.074

  1. The margin of error:

 

z x ơ/ √n = 1.96 x 6.75/√23 = (1.96 x 6.75√23) / 23 = (13.23 √23)/ 23 = $2.758 = $2.76

  1. The confidence interval for a 95% confidence level:

 

 ̅x ± z x ơ / √n =

 

  1. Statistics students at a state college compiled the following two-way table from a sample of randomly selected students at their college:

 

 Play chess Don’t play chess
Male students 25 162
Female students 19 148

 

Answer the following questions about the table. Be sure to show any calculations.

  1. How many students in total were surveyed?

 

25+19+162+148 = 354

  1. How many of the students surveyed play chess? 

 

25+19 = 44

  1. What question about the population of students at the state college would this table attempt to answer?

 

The population of male students who play chess (p₁) is equal to the population of female students who play chess (p₂).

  1. State Hºand Hª for the test related to this table.

 

Hº: p₁=p₂       Hª: p₁≠p₂

 

  1. Answer the following questions about an ANOVA analysis involving three samples.
  2. In this ANOVA analysis, what are we trying to determine about the three populations they’re taken from?

 

What we are trying to determine about the three populations that ANOVA is taken from is the difference in means. It’s a way to figure out if the survey or experiment results are significant.

  1. State the null and alternate hypotheses for a three-sample ANOVA analysis.

 

H0:μ1=μ2=μ3=…

Ha: At least one of the means is different from the others.

  1. What sample statistics must be known to conduct an ANOVA analysis?

 

Sample statistics of the sample size, mean and standard deviations of all comparison groups must be known in order to conduct an ANOVA analysis.

  1. In an ANOVA test, what does an F test statistic lower than its critical value tell us about the three populations we’re examining?

 

When the F test statistic is lower than its critical value this tells us that at least one of the three populations means we are comparing is different. This indicates that the null hypothesis is rejected.

 

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Research Critique – Part II

Research Critique – Part II

Write a critical appraisal that demonstrates comprehension of two quantitative research studies. Use the “Research Critique Guidelines – Part II” document to organize your essay. Successful completion of this assignment requires that you provide a rationale, include examples, and reference content from the study in your responses.

Use the practice problem and two quantitative, peer-reviewed research articles you identified in the Topic 1 assignment to complete this assignment.

In a 1,000–1,250 word essay, summarize two quantitative studies, explain the ways in which the findings might be used in nursing practice, and address ethical considerations associated with the conduct of the study.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

SAMPLE ANSWER

Research Critique – Part II

Quantitative Studies

Article 1

Noto, M. J., Domenico, H. J., Byrne, D. W., Talbot, T., Rice, T. W., Bernard, G. R., & Wheeler,

  1. P. (2015). Chlorhexidine bathing and healthcare-associated infections: A randomized clinical trial. JAMA313(4), 369-378. Doi:10.1001/jama.2014.18400
  2. Research Critique – Part II

Study Problem

Infections acquired during hospitalizations are the major causes of high mortality rates and increased the length of stay, which leads to increased healthcare costs for both patients and the health institutions. Health associated infections also result in increased healthcare system costs in the nation. The skin of patients in the Intensive Care Unit acts as a reservoir for pathogens (Noto, et al. 2015). Significant efforts are put to prevent and reduce the rate of infections through health practices designed to decrease the transmission of pathogens. Such practices include care of devices, bundles for insertion, isolation of multidrug-resistant organism’s patients, and hand hygiene (Noto, et al. 2015). Chlorhexidine can be used as one of the interventions in reducing bacterial burden, thus decreasing the rate of infections.

Significance of the Study to Nursing

Nurses should consider Chlorhexidine as a significant intervention in reducing the rate of infections for hospitalized patients. Chlorhexidine has a broad-spectrum topical antibacterial agent which decreases the bacterial burden, thus reducing the rate of infections when used daily during baths(Noto, et al. 2015). Various studies have reported that daily baths with Chlorhexidine are associated with reduced skin colonization with organisms that have multidrug resistance, reduced clostridium difficile infections, and reduced bloodstream infection rates.

Purpose of the Study

The main objective of the study was to assess if daily bathing with Chlorhexidine reduces associated healthcare infections for patients in the intensive care unit.

Research Question

Does daily bathing with Chlorhexidine reduce associated healthcare infections for patients in intensive care units?

How does the Article Answer the PICOT Question?

The PICOT question compares the effectiveness of daily bathing with Chlorhexidine and the effectiveness of daily bathing with soap and water in reducing the rate of Central Line-Associated Bloodstream Infections in patients admitted in the intensive care unit. The article answers the PICOT question by examining whether daily baths with Chlorhexidine reduces the rate of health-associated infections in patients admitted to the intensive care unit.

How the intervention and Comparison Groups in the Article Compare with those Identified in the PICOT Question

The PICOT question uses Chlorhexidine as an intervention. Chlorhexidine and soap and water are the comparison groups in the PICOT question. On the other hand, the article uses Chlorhexidine as the intervention group in reducing the rate of hospital-acquired infections.

 

Article 2

Holder, C., &Zellinger, M. (2009). Daily Bathing with Chlorhexidine in the ICU to Prevent Central Line-Associated Bloodstream Infections. JCOM16(11), 509-13. https://pdfs.semanticscholar.org/ace2/d11dfa4fab260bb5639c782b9baa0a1addad.pdf

Study problem

Approximately 80,000 patients in the intensive care unit in the United States are reported to have Central Line-Associated Bloodstream Infections every year. The cost of treating one patient is approximately 40,000 US dollars per patient every year. Most of the infections are preventable. Recent studies report that the use of Chlorhexidine wipes in hospitals reduces the rate of Central Line-Associated Infections (Holder & Zellinger, 2009). Therefore, daily baths with chlorhexidine wipes in traditional bathing procedures in the Intensive Care Unit should be considered as a significant intervention in the prevention of Central Line-Associated Bloodstream Infections.

Significance of the Study to Nursing

An academic medical center called Emory University conducted research that found out that the use of Chlorhexidine wipes for daily baths reduced the rate of postoperative sternal wound infections for patients in the cardiovascular surgery intensive care unit. As a result, interdisciplinary teams from various hospitals decided to incorporate a 2% chlorhexidine in daily baths for patients in the ICU(Holder &Zellinger, 2009). Therefore, nurses should consider the use of Chlorhexidine as a primary intervention in the prevention and reduction of Central Line Bloodstream Infections in hospitalized patients.

The Objective of the Study

The primary purpose of the study was to define a quality intervention for the acquisition of multidrug-resistant organisms and reduction of rates of Central Line Bloodstream Infections by using chlorhexidine wipes in daily baths of patients in the Intensive Care Unit.

Research Critique – Part II

Research question

Does the use of chlorhexidine wipes in daily baths act as a quality initiative in the acquisition of multidrug-resistant organisms and reduction of Central Line-Associated Bloodstream Infections for patients in the Intensive Care Unit?

Research Critique – Part II

How does the Article answer the PICOT Question?

The PICOT question researches the effectiveness of using Chlorhexidine in daily baths in reducing the rate of Central Line-Associated Bloodstream Infections in patients in the Intensive Care Unit. The article answers the PICOT question by describing the use of chlorhexidine wipes in daily baths in reducing the rate of Central Line Bloodstream Infections in patients admitted in the Intensive Care Unit.

How the Intervention and Comparison Groups in the Article Compare to those in the PICOT Question

The PICOT question considers the use of Chlorhexidine in daily as an intervention in reducing the rates of Central Line-Associated Bloodstream Infections in patients admitted in the ICU. Similarly, the article considers the use of chlorhexidine wipes in daily baths as an intervention in reducing the rate of Central Line Bloodstream Infections for patients admitted in the Intensive Care Unit.

Methods used in the Two Studies and how different they are

The article on Chlorhexidine bathing and healthcare-associated infections: A randomized clinical trial by Noto, et al. (2015) used a pragmatic cluster randomized crossover study method. The study used patients admitted in five different intensive care units for medical centers in Tennessee, Nashville between 2012 and 2013.

On the other hand, the study on Daily Bathing with Chlorhexidine in the ICU to Prevent Central Line-Associated Bloodstream Infections by Holder and Zellinger, (2009) used a study method where nurses came up with a bathing procedure which included bating frequency, technique, contraindications, required documentation, and bathing technique.

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Benefits and Limitations of the two Study Method

The main benefit of the study by Noto, et al. (2015) is that the crossover events enabled the assessment of control periods and two separate interventions which allowed intercluster variability as well as seasonal outcome variations. However, the main limitation of the study is that the method of the study did not give a chance for multiple comparisons of the results.

On the other hand, the main benefit of the study by Holder and Zellinger, (2009) is that the study method was controlled by advanced nurses and nursing leaders that ensured the accuracy of the findings. However, the limitation of the study is that use of chlorhexidine wipes was cumbersome to the patients, and they would also not feel as clean if they used it as an antiseptic liquid. As a result, it was difficult to make patients accept the use of chlorhexidine wipes.

Results of the Two Studies and their Implications to Nursing Practice

The results on Chlorhexidine bathing and healthcare-associated infections: A randomized clinical trial by Noto, et al. 2015 showed that during the chlorhexidine daily baths period; there was an occurrence of 55 infections. During the controlled bathing, there was an occurrence of 60 infections. No difference in the primary outcome between the two groups was observed after baseline adjustment. After the analysis of the results, there was no difference in primary outcome in individuals in the Intensive Care Unit.

The Implication to Nursing Practice

According to the findings of the pragmatic trial, daily chlorhexidine baths did not reduce the rates of Central Line Bloodstream Associated Infections in the Intensive Care Unit. The results did not support daily showers with Chlorhexidine for patients admitted in the Intensive Care Unit.

The results of the study on Daily Bathing with Chlorhexidine in the ICU to Prevent Central Line-Associated Bloodstream Infections by Holder and Zellinger, 2009 showed that the Bloodstream Infections reduced from 3.6 per 1000 patients to 1 per 1000 patients after six months of chlorhexidine bath procedure implementation.

Implications to nursing practice

According to the findings of the study, the use of chlorhexidine baths reduces the rates of Central Line-Associated Bloodstream Infections and resistant organism’s acquisition rates in patients admitted in the Intensive Care Units.

Ethical Considerations

Informed consent is one of the significant ethical considerations when conducting clinical research. Informed consent states that patients involved in research should voluntarily, intelligently, and knowingly give consent to the researchers to use their information in their study. Beneficence is another ethical consideration that includes professional; the mandate of the researchers to do significant and effective research that can better promote the welfare of the community health. The Institutional Review Board approved the two studies. Also, patient confidentiality was maintained. Besides, the patients that participated in the studies voluntarily gave consent to the researchers

References

Holder, C., &Zellinger, M. (2009). Daily Bathing with Chlorhexidine in the ICU to Prevent Central Line-Associated Bloodstream Infections. JCOM16(11), 509-13. https://pdfs.semanticscholar.org/ace2/d11dfa4fab260bb5639c782b9baa0a1addad.pdf

Noto, M. J., Domenico, H. J., Byrne, D. W., Talbot, T., Rice, T. W., Bernard, G. R., & Wheeler, A. P. (2015). Chlorhexidine bathing and healthcare-associated infections: A randomized clinical trial. JAMA313(4), 369-378. Doi:10.1001/jama.2014.18400

 

 

 

 

 

 

 

 

 

 

 

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Qualitative Research Critique and Ethical Considerations

Qualitative Research Critique and Ethical Considerations

Write a critical appraisal that demonstrates comprehension of two qualitative research studies. Use the “Research Critique Guidelines – Part 1” document to organize your essay. Successful completion of this assignment requires that you provide rationale, include examples, and reference content from the studies in your responses.

Use the practice problem and two qualitative, peer-reviewed research article you identified in the Topic 1 assignment to complete this assignment.

In a 1,000–1,250 word essay, summarize two qualitative studies, explain the ways in which the findings might be used in nursing practice, and address ethical considerations associated with the conduct of the study.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

SAMPLE ANSWER

Qualitative Research Critique and Ethical Considerations

Article 1

Johnson, J., Suwantarat, N., Colantuoni, E., Ross, T. L., Aucott, S. W., Carroll, K. C., & Milstone, A. M. (2019). The impact of chlorhexidine gluconate bathing on skin bacterial burden of neonates admitted to the Neonatal Intensive Care Unit. Journal of Perinatology39(1), 63. https://www.nature.com/articles/s41372-018-0231-7

Study Problem

Skin bacterial burden on the patients in the Neonatal Intensive Care Unit is a significant issue in the present world. The condition leads to high morbidity and mortality rates of patients in the ICU. Besides, the bacterial skin burden leads to extended stays in the hospital, which leads to increased healthcare costs for the patients. In the United States, more than 300 000 patients in the ICU are reported to have a bacterial skin burden (Johnson et al. 2019). Therefore, research needs to be done to solve the issues of Central-Line-Associated Stream Infection in the Neonatal Intensive Care Unit.

Qualitative Research Critique and Ethical Considerations

Significance of the study to the nursing practice

Antiseptic chlorhexidine gluconate is one of the primary measures that can be used to reduce bacterial infections in the central nervous and central line catheters. Chlorhexidine helps to prevent secondary and primary infections in patients because it has antibacterial activities which reduce pathogens in patient’s skin (Johnson et al. 2019). Therefore, nurses should consider the use of antiseptic chlorhexidine gluconate in the ICU since it is effective in preventing bacterial infections in patients as compared to regular soap and water bathing.

The objective of the study

The primary purpose of the study is to examine the effect of bathing with chlorhexidine gluconate on bacterial skin burden on patients admitted in the Neonatal Intensive Care Unit.

Research Question

Does bathing with chlorhexidine gluconate reduce bacterial skin burden in neonates admitted in the Neonatal Intensive Care Unit?

How does the article answer the PICOT question?

The PICOT question researches the comparison of the effects of bathing with Chlorhexidine and bathing with soap and water daily in decreasing the rate of central line-associated bloodstream infections in patients admitted in the Intensive Care Unit for one year. Therefore, the article helps answer the question by assessing the effectiveness of daily Chlorhexidine baths in reducing central line-associated bloodstream infections. The utilization of antiseptic chlorhexidine gluconate can be used as the primary intervention to fight bacterial load both in the central lines and central venous catheters. Therefore, chlorhexidine gluconate daily baths are imperative compared to regular baths using soap and water in the ICU unit.

How the intervention and comparison groups in the article compare with that one identified in the PICOT question

The PICOT question compares the effects of daily chlorhexidine baths and soap and water baths on the reduction of central line-associated bloodstream infections in patients admitted in the Intensive Care Unit. On the other hand, the article examines the effect of Chlorhexidine daily baths on central-line associated bloodstream infections by comparing the reduction level of central line-associated bloodstream infections between patients in the neonatal Intensive Care Unit who are exposed to Chlorhexidine and those who are not exposed.

 

Article 2

Savage, T., Hodge, D. E., Pickard, K., Myers, P., Powell, K., & Cayce, J. M. (2018). Sustained reduction and prevention of neonatal and pediatric central line-associated bloodstream infection following a nurse-driven quality improvement initiative in a pediatric facility. Journal of the Association for Vascular Access23(1), 30-41. Doi: 10.1016/j.java.2017.11.002

Study Problem

Central Line-Associated Blood Stream Infection (CLABSI) is a bloodstream infection that primarily leads to increased mortality and morbidity rates of patients in hospital. About 260,000 central line-associated bloodstream infections are reported in hospitals in the United States. Also, approximately 29,000 death cases related to the central line-associated bloodstream infections are reported every year. Nearly 29,000 US dollars are spent on treating each patient, which creates a burden of about 2.4 billion dollars on the US healthcare system every year.

Significance of the study to nursing

The suffering experienced by families and patients due to the central line-associated bloodstream infections acquired in the hospitals is immeasurable. Therefore, there is a need for nurses to focus on the prevention strategies for bloodstream infections in hospitals, especially in the Intensive Care Unit.

The objective of the study

Hospitals commit developing strategies to minimize the cases of central line-associated bloodstream infections which are the primary source of high costs of care by both patients and health institutions. Also, bloodstream infections are the leading causes of high mortality rates of patients admitted to hospitals. Therefore, the main objective of the study is to characterize the effectiveness and development of centralized Central Line-associated bloodstream infections prevention bundle in pediatric hospitals.

Qualitative Research Critique and Ethical Considerations

Research question

What is the effectiveness of centralized Central Line-Associated Bloodstream Infections prevention bundle in preventing CLABSI for patients in pediatric intensive care unit?

How does the article answer the PICOT question?

The PICOT question researches the comparison between the effects of daily baths with Chlorhexidine and with soap and water in reducing the rate of central line-associated bloodstream infections in patients in the Intensive Care Unit. The article answers the PICOT question by examining the effects of central line-associated bloodstream infections prevention bundle in reducing CLABSI in patients in the neonatal and Pediatric Intensive Care Unit. Therefore, the utilization of antiseptic chlorhexidine gluconate can be used as the primary intervention to fight bacterial load both in the central lines and central venous catheters. Chlorhexidine gluconate daily baths are imperative compared to regular baths using soap and water in the ICU unit.

How the intervention and comparison group in the article compare to those identified in the PICOT question

The PICOT question compares the effectiveness of two interventions, that is, daily baths with Chlorhexidine and regular baths with soap and water in reducing the rate of Central Line-Associated Bloodstream Infections for patients in the Intensive Care Unit. On the other hand, the article compares different interventions, that is, central CLABSI prevention bundles in reducing the rate of Central Line-Associated Bloodstream Infections in patients in the neonatal and pediatric intensive care unit.

Study methods used in each of the two articles and how different they are

The article by Johnson et al. (2019) used an observational study to determine the relationship between Chlorhexidine baths and Central Line-Associated Bloodstream infection prevention. The groin and arm skin bacterial growth were observed in non exposed patients, and 40 Chlorhexidine exposed patients in the Neonatal Intensive Care Unit. The exposed patients were given 2 % Chlorhexidine baths for Central Line-Associated Bloodstream infection prevention.

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On the other hand, the study By Savage, et al. (2018) used a research method where the researchers applied a retrospective time series to examine the effectiveness of various prevention bundles that were developed by nurses in infection control in neonatal and pediatric intensive care unit in 2006-2014. The research was subdivided in to post, peri, pre, and second peri-intervention periods depending on each bundles implementation status.

Results of the studies and their implications to nursing

The study by Johnson et al. (2019) indicated that the bacterial burden reduced after the patients took the first bath. However, the bacterial load returned to baseline after 72 hours. The concentration of residual CHG on the skin reduced with time as the bacterial burden increased.

Bathing with Chlorhexidine decreases the bacterial burden on the skin. However, the burden’s baseline returns after 72 hours. Nurses should be aware that CHG bathing twice a week may not be adequate in reducing the growth of bacterial skin burden in patients admitted in the neonatal Intensive care unit. Targeted interventions in the ICU such chlorhexidine gluconate daily baths can reduce the risk of CLABSI associated with using central lines and central nervous catheters. Thus, the study has shown the efficacy of chlorhexidine gluconate in intensive care patients and support is increasing in caring for non-ICU patients.

On the other hand, the study by Savage et al. (2018) showed that there was a significant reduction in unit Central Line-Associated Bloodstream Infection rates where all units were less than the corresponding National Healthcare Safety Network Central Line-Associated Bloodstream Infection rates after the study.

Prevention bundle for centralized Central Line-Associated Bloodstream Infection can be useful in universalizing central line care, improve and control the quality of care to help maintain low CLABSI rates in the hospital. Thus, the study has shown the efficacy of chlorhexidine gluconate daily baths in reducing the risk of CLABSI associated with the use of central lines and central nervous catheters in intensive care patients.

Ethical Considerations

When conducting research, it is vital to maintain the confidentiality of patient information. Secondly, the study should be supported and approved by the Institutional Review Board.  The Institutional Review Board approved the two articles. Besides, participants of the studies were chosen voluntarily, and their health information was confidentially maintained.

References

Johnson, J., Suwantarat, N., Colantuoni, E., Ross, T. L., Aucott, S. W., Carroll, K. C., & Milstone, A. M. (2019). The impact of chlorhexidine gluconate bathing on skin bacterial burden of neonates admitted to the Neonatal Intensive Care Unit. Journal of Perinatology39(1), 63. https://www.nature.com/articles/s41372-018-0231-7

Savage, T., Hodge, D. E., Pickard, K., Myers, P., Powell, K., & Cayce, J. M. (2018). Sustained reduction and prevention of neonatal and pediatric central line-associated bloodstream infection following a nurse-driven quality improvement initiative in a pediatric facility. Journal of the Association for Vascular Access23(1), 30-41. Doi: 10.1016/j.java.2017.11.002

 

 

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Action Plan in Counselling

Action Plan in Counselling

If counseling is all talk and no action, it is not effective counseling. The problem is that clients encounter many barriers in carrying out actions they identify in the counseling process.

Write a 750-1,000-word paper discussing action planning and overcoming barriers for client treatment. Please use headings and include the following in your paper:

1.      Discuss the principles for effectively implementing an action plan.

2.      Describe at least five barriers that might interfere with client implementation of the action plans that are created. Include a case example of each barrier.

3.      Outline a counselor intervention that would help to overcome each barrier.

4.      A list of your local community resources for different types of needs.

5.      Outline an aftercare plan that utilized local community resources.

Include at least three scholarly references in your paper.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

SAMPLE ANSWER

Action Plan in Counselling

Introduction

Mental health is an important health field that is helping a lot of people who in the past struggled in silence. For it to be effective, it is important to understand the specific steps that needs to be taken as well as possible barriers to effective treatment and how to overcome them (Treatment, 2014). The following is an analysis explaining principles of effective action plan implementation, its barriers and ways to address the barriers. It also explores possible resources available to assist the clients and how they can be used for the benefit of the patient.

Action Plan in Counselling

Principles of Effective Action Plan

The first principle for an effective treatment plan is that of clarity in that all the activities that are to be done need to be clearly defined as well the period they will run. The second principle is that of sufficiency. It explains that for an action plan to be effective then all of the objectives that were defined before its implementation are done (Treatment, 2014). The third on is that of resources. For an action plan to be effective there needs to be very specific resources that are available to the person. Principle of resources require that the resources need are well explained as well as how they will be availed. Finally, the action plan needs to meet the principle of flexibility. It explains that for an action plan to be effective, then it needs to be one that can respond effectively to new changes as well as emerging barriers and opportunities.

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Barriers

One of the barriers to be addressed is stigma. A lot of people suffering from mental problems are stigmatized which can make them not want to take advantage of the resources available to address the problems for fear of being stigmatized. For example, people tend to categorize any person receiving any mental health related care as being crazy which can inhibit the willingness from seeking help so as not to be categorized as such. Another barrier is financial (Treatment, 2014). Treatment can be expensive and implementation of action plan will need specific resources that might need to be paid to acquire. Many who do not have the financial capacity to pay for these resources can struggle to effectively address their problem. For example, some action plans might need insurance to be effective and if a person cannot afford a cover, then it will be hard to effectively implement it.

Another barrier is reluctance to face problems. A lot of people that need counselling tend to be unwilling to take the necessary steps for them to get better due to various reasons such as being in denial (Drake & Latimer, 2014). For example, an action plan might need an individual to apologize for something that they did and if unwilling, then it is hard to implement that part of the plan. For those people, it will be hard to get the right assistance because they do not feel like the need it in the first place. Many of them also do not feel like counselling and the steps that need to be taken will be effective and the end up not either seeking help or following up on everything that needs to be done. Other health problems can also be a source of barrier to effective implementation of an action plan. For example, those suffering from health problems such as HIV/AIDS or with chronic diseases that are painful may be unable to be actively involved in all required activities. Finally, there are also many system problems that can also result in barriers. For example, if a person was getting help from Medicaid to implement the action plan and end up taking a better paying job, then they will not be eligible to getting the financial help anymore.

Resources available for Various Needs

There are various resources available to those who need them. For information, some of the online resources include American psychological association, American Psychiatric Association, and Psychology Today websites. For military and Veterans, they can get the help they need from the veteran affairs offices, military pathways offices and the national association on mental illness. For the young people, some resources that are available to them include the US office of adolescent health, Jed foundation, youth.gov and law lifeline (Sanetti & DiGennaro Reed, 2014). The Mental Health America (MHA) is also a viable option for many and is community based. Among the resources it provides include screening tools and approach to getting help among others.

Action Plan in Counselling

Aftercare Plan

A good after plan provides assistance after the action plan implementation to ensure that a person continue of the upwards trajectory of recovery. A good option to consider is joining a support group. The aftercare plan needs to start with finding a good after care group near and individual and cites such as Mental Health America can help (Drake & Latimer, 2014). One will then need to approach the group which is in most cases made up of people recovering from similar problems. It gives them a chance to share and talk about their experiences as well as offer support to each other. This can help a person feel strengthened and have people to talk to during challenging times.

Conclusion

Mental health is an important issue in America and action plans are central to an effective recovery. They need to have some specific principle to be effective. It is also important to identify barriers that can inhibit successful implementation and devise ways to eliminate them. Finally, one needs to have an effective aftercare plan to assist the person recovering to keep moving forward.

References

Drake, R. E., & Latimer, E. (2014). Lessons learned in developing community mental health care in North America. World Psychiatry, 11(1), 47-51. doi:10.1016/j.wpsyc.2012.01.007

Sanetti, L. M., & DiGennaro Reed, F. D. (2014). Barriers to Implementing Treatment Integrity Procedures in School Psychology Research. Assessment for Effective Intervention, 37(4), 195-202. doi:10.1177/1534508411432466

Treatment, C. F. (2014). Enhancing Motivation for Change in Substance Abuse Treatment.

 

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Vargas family-Narrative Therapy

Vargas family-Narrative Therapy

Identify one member of the Vargas family whose dominant story could use some rewriting. Read the workshop notes on Reauthoring Conversations.

Part 1: In 250-300 words, write a counseling note for the client’s file. In this note, describe any exceptions to the problem that you have identified and develop scaffolding questions to ask the client in your next session, one in their landscape of action and one in their landscape of identity.

Part 2: Put yourself in the client’s shoes and, as the client, write a reauthoring version of their story that is 500-750 words in length. It should incorporate the exceptions and responses to the scaffolding questions from Part 1. Use narrative language when applying this reauthoring technique.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the directions in the Student Success Center.

AttachmentsPCN521-RS-SubmittingMultipleAttachments.pdf PCN521-R-T7CaseStudy.docx

 

SAMPLE ANSWER

Vargas Family Case Study: Narrative Therapy

Part 1

Counseling note

Patient’s name: Elizabeth Vargas

Type of session: family session

Date: 17th September 2019

The progress of the patient since the last session: the patient seems agitated and concerned about everybody else in the family but herself. The patient reports progress in the family’s weekly soccer matches. She reports seeing Bob Vargas more and Frank’s behavior is improving. Today, she reports that her father in-law and mother in-law Linda and Tim, are affecting their grandson’s drug use treatment process. She specifically requested for the entire family including Linda and Tim, to come for this session.

Observations about the patient: the patient looks tired and a bit disheveled. Her eyes are red and her cheeks are flushed indicating that she has been crying. She is always on time for the family sessions but complaints when other family members are late.

Vargas family-Narrative Therapy

Review of action items: the patient reports that the family has been hosting the weekly soccer matches as directed. She also notes that Frank and Heidi are getting along much better. However, she confesses to not enjoying the soccer matches. She does not like outdoor activities.

Session Description: the family session involves the entire family including Linda and Tim. The main issue in question is Geoff’s near drug overdose and how his father’s death has affected him. Elizabeth further states that Linda and Tim are not helping the situation by giving their opinions about what should be done. Elizabeth also thinks that Linda should not have called Geoff’s school therapist since she was not his mother. Linda disagrees and tells Elizabeth that she knows what is best for her grandson. This sentiment angers Elizabeth who asks to leave the session.

Main Issue of the session: The main issue is Geoff’s drug overdose and the resulting effect on the family.

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Scaffolding Questions

Landscape of action question: do you think Geoff’s father’s death resulted in Geoff taking drugs and finally overdosing?

Landscape of identity question: what if Linda and Tim stopped trying to help Geoff control his grief, will this help him become better and hopefully stop using drugs?

Vargas family-Narrative Therapy

Part 2

Thank you very much for agreeing to see the entire family. I am concerned about my nephew Geoff and his recent drug use. Geoff has been moody and has also been performing poorly in school. We thought that this change in behavior was due to his father’s death. Therefore, we did not pay any extra attention to it seeing that everyone handles grief differently. However, Geoff was recently rushed to the hospital after a near overdose. I think that Geoff’s father’s death resulted in him taking drugs and nearly overdosing. Since that day, our family has been in a crisis. Linda decided to call Geoff’s school therapist to find out more about Geoff’s behavior but was turned down. Tim on the other hand, despite his good intentions, is making matters worse. He took Geoff out for camping against Katie’s wishes. I believe that Linda and Tim’s involvement is not helping Geoff. Linda being headstrong is already telling Katie about her disappointing encounter with the school therapist. This in turn forced Katie to contact the school therapist who informed her that she was not ethically allowed to disclose Geoff’s information to Linda since she has to maintain the patient’s confidentiality. In addition to informing Katie about the therapist’s encounter, Linda continued to offer alternatives and interventions she believes will help Geoff. I think Linda’s influence and persuasive nature has convinced Katie to disregard the therapist’s advice of helping Geoff forget his grief. If Linda and Tim stopped trying to help Geoff control his grief, he would be able to stop taking drugs.

Vargas family-Narrative Therapy

I called you earlier to request you to see our family including my father-in law and mother-in law because I am familiar with you and I have seen tremendous changes in my family more specifically, in Frank. I have been struggling with taking care of Frank and his special needs for a while now. Bob has not made it any easier for me. He thinks that I am exaggerating everything. He still thinks that Frank is just being a boy. I am getting frustrated by his comments when all I want is for our family to get better. Since our last visit, we have been meeting up at the local park and playing football for at least an hour a day. I personally do not like outdoor activities but I have found the football matches beneficial for the entire family. For example, last Wednesday, we divided ourselves into two teams and for the first time, Frank requested to be paired with Heidi and not with Bob. Normally, Frank is aggressive towards Heidi and often physically pushes her around. Overall, I appreciate our sessions as a family and by including Linda and Tim; I foresee tremendous progress in our future.

 

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Floating Improvement Program

Floating Improvement Program

In this assignment, you will propose a quality improvement initiative from your place of employment that could easily be implemented if approved. Assume you are presenting this program to the board for approval of funding. Write an executive summary (750-1,000 words) to present to the board, from which the board will make its decision to fund your program or project. Include the following:

  1. The purpose of the quality improvement initiative.
  2. The target population or audience.
  3. The benefits of the quality improvement initiative.
  4. The interprofessional collaboration that would be required to implement the quality improvement initiative.
  5. The cost or budget justification.
  6. The basis upon which the quality improvement initiative will be evaluated.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful

I wanted it to be written over nurses floating to other units and them getting properly trained. I work on a mom/baby unit

nurses get stressed from floating to other units

 

SAMPLE ANSWER

Floating Improvement Program

Introduction

Quality health improvement programs are proven ways health organizations can deploy to meet the competitive demands of patient protection frameworks such as Medicare. The need for efficient supply chain processes that improve patient outcomes as well as limiting treatment costs imply strategic alternatives to traditional healthcare delivery. This essay discusses alternative approaches to nurse floating; outlining improvement approaches aimed at benefiting both the nurses, patients and the health organization. Also discussed is the required interprofessional collaboration, budget justification and the basis for evaluation.

Floating Improvement Program

Program’s Purpose and Target Population

Floating of nurses across different units in my health organization has proved a key challenge for most of the nursing staff. Moving these caregivers from their units of specialization to provide services in unfamiliar units presents most health workers with different concerns that range from anxiety and uncertainty to severe challenges such as inability to provide timely and adequate care (Trossman, 2014). This indeed compromises the overall quality of health outcomes thereby necessitating floating interventions that relieve nurses of the pressure as well as providing patients with quality care.

Adopting a Nursing Float Development Program admits that nursing shortages are a reality in most care units and that effectively managing floating allows deprived units the benefit of additional nurses from different units during their time of need (Larson, Sendelbach, Missal, Fliss, & Gaillard, 2012). The knowledge gap seen in nurses working in new environments will be addressed by developing a skills acquisition program that aims at training nurses in common skill sets. This directly boosts the confidence of float nurses away from their professional units (Trossman, 2014). Pediatric and cardiac nurses, for example, will receive training in emergency care resulting in quality emergency outcomes. This approach will be adopted for individual or groups of nursing units on a voluntary basis allowing nurses to train in skill sets of their preferences. This approach assures better nurse participation in floating programs.

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Establishing a dedicated pool of floating nurses will also be mandated under the nursing quality improvement program. This initiative will require the health organization to hire additional nursing personnel who will be imbued with the scarce nursing resources within the facility such as cardiac and emergency care skills. Having no home unit implies that this pool of caregivers will be easily programed to meet the day to day care requirements in most of the units. Ensuring that highly qualified and skilled nurses form this pool promises efficient services even in highly technical circumstances.

Developing a comprehensive floating resource plan will equally contribute to the efforts of addressing floating challenges. The resource plan primarily equips the float nurse with the unit’s information including team contact addresses, documentation protocols, safety procedures, and shift routines (Larson et al., 2012). Adequate training in some of these standard procedures ensures that floating nurses integrate positively with the unit nurses for improved health delivery and patient satisfaction.

Program Benefits and Interprofessional Collaboration

A major influence of the program is to relieve nurses of the tension and uncertainty they face whenever they encounter circumstances that significantly differ from their accustomed work stations (Trossman, 2014). This effort acknowledges that employee satisfaction is a major contributor to positive health outcomes. The Nursing Float Development Program achieves these aims by ensuring float nurses are well adapted to different units to help address the chronic challenge of nursing shortages. Reducing the stress and anxiety faced by float nurses by implementing and developing various resources that direct nurses in new environments ensures that float nurses are more confident of their skills and the resources at their disposal. This is a clear way of boosting their efficiency and responsiveness in unfamiliar units (Trossman, 2014).

Developing nursing competencies by addressing their knowledge gaps in different skill sets enhances their relevance in the healthcare setting. Being able to adequately provide services in more than a single specialist unit increases the demand of the individual nurse opening them up for better opportunities in their practice. Another significant benefit of the improvement program that contributes to a vibrant workforce is the program’s capacity to limit involuntary floating which acts as a key source of nurse’s dissatisfaction (Larson et al., 2012). Investing in a dedicated floating pool implies that floating needs are handled with a predetermined regularity which eliminates the uncertainty faced by both armature and experienced nurses.

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All efforts towards improving the nursing experience during floating are a major contributor of lower turnovers since this lessens the burden faced by the nurses as well as creating enabling environments that ensure patients obtain the highest quality care (Trossman, 2014). Effectively covering the patient needs is a quality outcome that the improvement program is determined to achieve.

Interproffesional collaboration on the other hand admits that the nursing environment is a sophisticated area and that collaboration from other health professionals is pivotal for a sustainable healthcare system. Effective development and implementation of the floating program will involve the contribution of practically all nursing units within my care facility. Nursing teachers also play an essential role in the training of float nurses. Ensuring that float nurses are well versed in different skill sets required in the hospital’s health units signifies the role of interprofessional collaboration. Physicians working throughout the organization should also be aware of the presence of float nurses in their work stations and provide the adequate support needed for smooth operations. Technicians in all units also provide essential collaborative support by equipping float nurses with the technical knowhow required to operate equipment of different orientations.

Budget Justification and Evaluation Metrics

             A significant amount of the program budget will go towards the training of nurses in the organization and developing a float pool. Training programs will involve each nurse picking at least one unit which they would be confortable to serve as a float. The training aims to equip about 220 nurses, in the process incurring about $950,000. This amount will cater for all training needs including the allowances for the nurses. Another $1,200,000 will be utilized to establish a dedicated float pool of highly skilled nurses. 40 specialist nurses are to be hired to serve in this capacity.

Predominant evaluation parameters will include patient satisfaction scores, turnover rates, and the costs of care. Patient satisfaction is a key determinant of the program’s success enabling the organization to see its impact on patient welfare. A reduction in nurse turnover rates will demonstrate the impact of the program in improving the working conditions of the float nurses. The costs of administering basic healthcare should also be minimized through increased efficiency of service delivery. This makes the cost of healthcare after the program an important evaluation parameter.

Conclusion

The shortage of nurses in healthcare provision presents health organizations with a unique challenge. Floating is one strategy that institutions can adopt with increased chances to better patient outcomes and minimize instances of nurse turnovers. The Nursing Float Development Program aims to equip nurses with essential skills in several health units to increase their effectiveness in new care environments. Establishing a float pool of specialized nurses is an initiative that seeks to mitigate the consistent shortage of nurses throughout the different units of care in my health organization.

References

Larson, N., Sendelbach, S., Missal, B., Fliss, J., & Gaillard P. (2012). Staffing patterns of scheduled unit staff nurses vs. float pool nurses: A pilot study. Medsurg Nurs, 21(1), 27-39.

Trossman, S. (2014). On less familiar ground: Strategies aim to reduce random floating, improve the experience. Am Nurse, 46(1), 7. Retrieved from www.theamericannurse.org.

 

 

 

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Ventilator Alarms in Nursing Informatics

Ventilator Alarms in Nursing Informatics

This is a Master level paper. The professor want us to use the resourses he provided. APA format, in text citation, refernce page and 100% originalNo running head please .

 

Describe the project to be propose.

Be specific, what kind of project are we proposing?

For example

1.     How to improve upon medical alarms system such as

2.     IV pumps alarms

3.     Ventilator alarms

4.     Patient initiated call bells

5.     Staff initiated code-alarms

Must be interface with electronic medical record and wireless communication devices for standardization.

Clearly define a project, something we want to invent to promote better nursing care and patient safety. It’s should be a technology. Not nurse ratio due to computer system

Identify the stakeholders impacted by this project.

Who are our stakeholders? You have to mention. Be specific

Explain the patient outcome(s) or patient-care efficiencies this project is aimed at improving and explain how this improvement would occur. Be specific and provide examples.

Identify the technologies required to implement this project and explain why.

Identify the project team (by roles) and explain how you would incorporate the nurse informaticist in the project team.

SAMPLE ANSWER

Ventilator Alarms in Nursing Informatics

Introduction

Nursing informatics is a revolutionary health discipline that commits to adopting a data intensive approach to population health. By utilizing advances in information technology and computer systems, nursing informatics arms the nurse with tools that enhance her data gathering and processing abilities. This project proposal aims at installing ventilator alarms systems in the respiratory department of my health organization and interfacing the system with electronic medical records. Enhanced decision making from therapists is a key drive for this improvement program. Other discussion topics include the range of stakeholders involved, patient outcomes projected, and the relevant technologies for implementation.

Ventilator Alarms and Nursing Informatics

Project Description

            Ventilators are life-critical systems employed by intensive care givers such as emergency care providers to aid patients who are at risk of respiratory failure (Korniewicz & Kenny, 2017). The equipment is comprised of air reservoirs that are pneumatically compressed to deliver a mixture of air and oxygen to the patient. To meet the different patient needs, ventilators can be adjusted to deliver the precise ventilation. Invasive and non-invasive approaches are adopted for different patients (Korniewicz & Kenny, 2017).

Ventilators play a life-saving role by ensuring care nurses are informed of the patient’s progress. This is achieved through a system of alarms that warn of any excesses in inhaled and exhaled volume measurements (Korniewicz & Kenny, 2017). Key alarms considered include: high airway pressure alarms, low airway pressure alarms, low and high rate alarms, high and low expiratory volume alarms, and high and low inspiratory volume alarms (Korniewicz & Kenny, 2017). The magnitude of the different causes that result in these ventilator alarms makes it challenging for intensive care nurses to exactly pinpoint the reasons for the alarms (Korniewicz, Clark & David, 2008). This hinders effective response from the care givers leading to relatively lower patient outcomes (Gazarian, 2014).

Ventilator Alarms in Nursing Informatics

Hence, the approach adopted by this project proposal will involve developing extensive interface networks with the electronic medical records and linking the alarm systems with remote wireless devices (Korniewicz & Kenny, 2017). This program envisions that ventilator alarms are effectively communicated to nurse informaticists and therapists in the respiratory department. In cases where several patients are on ventilation these improved systems will enable faster detection and response from care givers.

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Program Stakeholders

            Critical respiratory care patients form the bulk of patients with a direct interest in the program. Long term dependence on ventilators is necessary for patients with conditions such as chronic obtrusive pulmonary disease (Korniewicz & Kenny, 2017). This may call for invasive ventilation methods making the patients a key target of the ventilation enhancement program. Non-invasive methods are also applicable to pulmonary patient who may only require ventilation during rest or sleep. Their reliance on ventilators marks them as a key target group. Ventilators are also necessary equipment to support patient breathing when under anesthesia.

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As health reforms are increasingly geared towards a patient centric approach, considering pulmonary patients as key stakeholders’ means that more attention will be directed towards ensuring better outcomes for this patient population group. Ventilation in Intensive Care Units (ICU) is a process with life/death implications hence the need to consider pulmonary patients as vital stakeholders. This helps to channel efforts towards more efficient processes with better patient satisfaction scores.

Respiratory therapy staffs including clinical and nursing personnel form another important group of program stakeholders. This group should particularly be versed with information technology skills that will facilitate their effective handling of ventilators and the integrated alarms systems (Mamta, 2014). Setting the ventilator alarm parameters to suite individual patient needs is a highly technical skill that requires the direct participation of the interprofessional personnel in the quality program.

Patient Outcomes and Efficiencies

            An essential component of the ventilator program is the management of the alarm systems. Establishing some of the industry’s best practices within the respiratory department will mean that the department’s nurses will respond more effectively to the demands of the patients. Clearly establishing the alarms for the different parameters such as minute volume, respiratory rate, and exchanged tidal volumes implies that the nurse will have an upper hand in decision making that facilitates effective responses (Korniewicz & Kenney, 2017). The result of this improved efficiency implies that patients will have better satisfaction scores from the improved patient outcomes.

Critically also, nurses working with patients under ventilator care will have less burden occasioned by the analysis of the different ventilator alarms. Ventilator alarms typically vary depending on the manufacturer making it difficult for the therapists to identify which conditions are leading to the alarm (Korniewicz & Kenney, 2017). Standardizing the alarm systems goes a long way in ensuring that nurses are only left with the critical task of attending to the patient’s needs (Saeed, Villarroel, & Reisner, 2011). These improvisations imply that nurses will be better satisfied with their contributions thereby lowering their turnover rates.

Integration of the ventilator alarm systems with electronic patient records and related databases contributes to collaboration of clinical services including analysis of patient data from remote locations (Saeed et al., 2011). This technology considers that clinicians may not always be available on site but remote tools such as phone applications enable their contribution in decision making. This effectively tackles the challenge of physician shortage experienced in respiratory departments.

Relevant Technologies

            An essential technological boost to the ventilator alarm systems will involve the adoption of alarm notification through applications on Wi-Fi phones. These notifications will help therapists to pinpoint the locality of the alarms in instances where a number of patients are on ventilators. Remotely analyzing the patient conditions from their phones also saves nurses the time required to make rounds by the patient bedsides (Mamta, 2014). This quality improvement promises rapid action from the clinicians and nurses for enhanced outcomes.

Applying advanced heuristics such as AI means that ventilators will be able to assist nursing informaticists and other interprofessional in decision making. This is achieved by the computational abilities of the ventilators to determine the appropriate course of action from the knowledge base acquired throughout their service period as well as information made available by informaticists from other ventilator databases (Saeed et al., 2011).

Specifying the alarm priorities of the ventilators will be substantial since nurses will be able to work more effective by reacting to high priority calls first. This technology contributes to lessening nurse fatigues by appropriately determining the course of action. Ventilator auto correction systems will be in place to effectively resolve the challenge of false alarms which are common in the respiratory intensive units (Korniewicz & Kenney, 2017).

Project Team

        Clinical and nursing staff form an essential core required to ensure the sustainability of the ventilator program. Keeping track of the various signals and alarms is essential to the health of the patient making the decision making input from the respiratory therapy staff invaluable. Administration of treatment contributes to improved respiratory outcomes. The nurse informaticists also play a critical role of data management. This is achieved primarily through data gathering, and analysis frameworks that enable a harmonious interoperability of the different technologies necessary for quality respiratory care (Mamta, 2014). Informaticists also contribute to information decision making by prioritizing vital information from the multitude of data collected by the electronic health systems. The biomedical technologist is also a vital component of the staff. By effecting maintenance services for the ventilators, he ensures that the systems are reliable enough for highly accurate decision making (Saeed et al., 2011).

Conclusion

            The enhanced ventilator alarms program is a quality improvement initiative aimed at higher pulmonary patient satisfaction rates. Allowing ventilators to access patient databases enhances record keeping and decision making capabilities of the therapists. Providing nurses and clinicians with remote monitoring systems such as mobile phones immensely reduces the workload of the nurse who can now dedicate more time to decision making.

References

Gazarian, P. K. (2014). Nurses’ response to frequency and types of electrocardiography alarms in a non-critical care setting: a descriptive study. Int J Nurs Stud, 51(2), 190–197.

Korniewicz, D. M., Clark, T., & David, Y. (2008). A national online survey on the effectiveness of clinical alarms. Am J Crit Care, 17(1), 36–41.

Korniewicz, D. M., Kenney, B. D. (2017). Preventing Ventilator Alarm Fatigue. Retrieved from http://respiratory-care-sleep-medicine.advanceweb.com/Features/Articles/Preventing-Ventilator-Alarm-Fatigue.aspx.

Mamta, A. (2014). Nursing Informatics: The future now. IOSR Journal of Nursing and Health Science. 3(2). Retrieved from www.iosrjournals.org.

Saeed, M., Villarroel, M., & Reisner, A. T. (2011). Multiparameter intelligent monitoring in intensive care II: A public-access intensive care unit database. Critical Care Medicine, 39(5), 952–960.

 

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Week 3 Discussion_Strategic Plan

Week 3 Discussion_Strategic Plan

2 peer responses to Group A and Group E. They are posted below.

 Peer responses By Day 7

Individually respond to at least two other teams in one or more of the following ways:

  • Provide recommendations for another team’s content.
  • Offer insights on how your team’s content supports another team’s content.

Group E, Week 3 Discussion

In the scenario presented regarding Millersville Regional Medical Center with a strategic plan requiring an evaluation, there are certain factors and components that need to be considered (Ginter, Duncan & Swayne, 2018). In the process of, the center needs to apply strategic controls, which are some of the factors to consider when looking at the center’s ability to optimize its strengths and opportunities. Premise control is used in order to help measure and determine outside environmental factors and this strategy can potentially be used in order to help the health care organization when it comes to determining influx of immigrants in the surrounding area (Clear Point Strategy, n.d.).  For example, the center’s ability to recruit more physicians and also retain the current workforce in the face of competition and better alternatives such as better pay and amenities for its workforce from its competitors.

Also, implementation control could possibly be used in order to help create and track an overall plan that can be used in order to help decrease wait times, increase funds, as well as increase the number of health care professionals.  It is because, at the implementation of the strategic plan, the center needs to ensure that in the event of unforeseen circumstances like the influx of patients, the strategic plan will not need any adjustments. These adjustments, in most cases, are costly, time-consuming, and may trigger loss of clients to competitors.

Week 3 Discussion_Strategic Plan

The third strategic control the organization should utilize is the special alert control. “A special alert control is the need to thoroughly, and often rapidly, reconsider the firm’s basis strategy based on a sudden, unexpected event” (Strategic Control, 2018). This strategic control would benefit the organization because the organization has seen an unexpected spike in the number of patients that visits the hospital.

It is vital for every strategic plan, even at its time of evaluation to put in place some monitoring tools. In this case of Millersville Regional Center, a monitoring tool such as the Gantt Chart, which is a bar chart used to monitor and show a project plan and its advancement or progress over time, is crucial in its strategy. It is because, in the moment of monitoring progress, the center would have set appropriate measures to prevent the depletion of its charitable care budget early in the year. The use of a balanced scorecard is essential because of its purpose in tracking and isolating four separate areas, also known as legs. These legs include learning and growing, business processes, customers, and finance (Cebeci, 2018). In the scenario, the strategic plan needs this tool to evaluate the center’s ability and capacity to handle some issues. These issues include the increase of patients, better pay, and amenities for its workforce through available resources. It will give the center an idea of where immediate or critical improvements are required or the need for additional resources. A dashboard would also help the center to focus on its mission and ensure that its strategy is effective.

Week 3 Discussion_Strategic Plan

Two tactical objectives the organization can use to address its operations requirements are to reach out to the nearest universities to create connections with nursing and healthcare students so that they may find interest in becoming employed at the facility when they graduate. By networking, the hospital can establish connections while also making students aware of the overall benefit of using their talents in rural communities. Another tactical objective the hospital should consider is involving staff members with their input on creative and innovative ways to improve the quality care and rewarding the employees for their involvement. Regardless of job title, all staff members may have ideas that could benefit the organization. Including staff also shows them that the organization cares about them and their ideas regarding the company.

References

Klipfolio. 2001. What is a data dashboard? Retrieved from https://www.klipfolio.com/resources/articles/what-is-data-dashboard

Strategic Control. 2018. Strategic Management: Formulation and Implementation. Retrieved from https://www.strategic-control.24xls.com/en143

S. Epstein. September 2013. Using the Internet in Your Job Search. Retrieved from https://career.fsu.edu/sites/g/files/imported/storage/original/application/27ba368e3cba4cc02d2931a2be2f4f3d.pdf

Clear Point Strategy. (n.d). Strategic control: Breaking down the process and techniques.Retrieved from https://www.clearpointstrategy.com/strategic-control-process/

Cebeci, U. (2018). Building hospital balanced scorecard by using decision support approach. IIOAB JOURNAL, 9(6), 42-47.

Ginter, P. M., Duncan, W. J., & Swayne, L. E. (2018). The strategic management of health care organizations. John Wiley & Sons.

 

Group A Week 3 Discussion

Scenario:

The board of directors of Elite Healthcare formulated and implemented a strategic plan to address the city’s rapidly growing population (11% increase per month), which is demanding greater access to quality, innovative patient care. However, they failed to evaluate the implementation of the plan, and over time, many employees became overworked because of the increased demand for services, which has led to a higher percentage of work-related employee and patient injuries. The current work environment has adversely impacted employee morale and the organization’s ability to recruit new talent. Moreover, patients have started seeking care across town even though it is a much longer commute

Strategic controls, monitoring tools, and tactical objectives might be used to address date and tracking via medical records.  As an organization using tolls to monitor data from medical claims, pharmacy claims, and electronic medical records can impact millions of lives. Strategically leveraging this data to hone and train predictive models for population health management, fostering innovation and research across health care will also be impactful.  Although the size of the data assets would be impressive, it’s the enrichment and curation that makes most valuable to the health care industry. Also, there will be fewer negative consequences with expressed objectives and goals. Organizations are built with the goal of profitability through processes in mind. The organizational control approach incorporates goals and the strategy used to reach them.

Week 3 Discussion_Strategic Plan

As far as tactical objectives to leverage operational requirements the organization should revamp the scheduling process on the front line. Offer and request should be taken into consideration in scheduling surgeries and other non-life-threatening processes. Patients should be planned for such processes on days when owing to a busy night in the ED, the hospital is less likely to have a spike in patient volume. Consider alternative care delivery techniques. The organization can attempt to treat patients in different ways to alleviate the burden of heavy wait times. For patients with less severe problems with ED, telemedicine may be one option. The organization can also partner directly with neighboring emergency medical centers and other healthcare institutions to provide patients with an option for ED to reduce their waiting time. Incorporate the preferences of patients. Patients, not providers, should be the focus of scheduling. The organization must, therefore, reach out to find out what types of modifications would best suit the requirements of patients. Some clinics have provided patients with access to schemes where they can create their own ED appointments for less critical problems –or offer patients an estimated time to wait over the phone before arrival so they can make the appropriate arrangements. (White, 2015) These solutions should help with accommodating the imbalance of supply and demand that the organization is facing.

Monitoring tools used are data-driven tools, Epic, and good old fashion workgroups and meetings. We have weekly meetings with our vendor to ensure that the project is up to speed and this issue is being worked through. Monitoring this is no easy task but through communication and a strong project plan, we get it done. We rely on the data from the groups and their feedback to drive our conversations and push us.

Week 3 Discussion_Strategic Plan

In addition, we will use a balanced scorecard to align the daily work of all employees with the strategic plan aimed at increasing access to quality care and measure progress towards our strategic target (Walston, 2018). Taking the organization’s internal strengths and weaknesses into account, our objective of delivering quality care will lead us to the tactical goal of matching a reasonable patient-provider ratio that will prevent employee burnout. The balanced the scorecard will, at all times, help keep the patient-provider ratio proportionate to that determined in the strategic plan; a ratio that will prevent excessive workloads and employee burnouts.

One tactic used is meeting the NCQA standards for the health risk assessment to ensure that our organization meets the guidelines and requirements for reimbursements and the standards of care.  This is a necessary objective for all parties involved.

Another objective is weekly meetings to ensure that no other issues will arise and the project is on track. To me, nothing beats good old-fashioned meetings and face-to-face conversation. Meeting weekly increases the amount of communication and ensures that the project will get done. To me, this is very necessary and one of the strongest tasks. We go over project plans, updates, questions, concerns, and the timeline. We all count on this meeting to get our product done. Behrouzi, Shaharoun, and Ma’aram note this in their piece as a useful measure (Behrouzi, F., Shaharoun, A. M., & Ma’aram, A., 2014).

Diving deeper, an example within the workplace comes from work in an ICU as a respiratory therapist. One employee noticed that the balloon cuff on are vented patients was deflating between shifts causing patients not to get the exact volume they need to keep their lungs open while they were on the ventilator. Of course, this drives the nurses crazy when the ventilator is alarming. So the employees came up with a plan to do cuff checks at the beginning and end of our shifts.  Employees would check all patients that were vented at the end of the month as our milestone review and notice deflation was down. This allows vented patients to get the volume they needed to get their lungs healthier until they come off the ventilator.

Week 3 Discussion_Strategic Plan

Stepping further, with monitoring tools, these employees used a data dashboard tool to analyze the data from doing the cuff checks. They could track the average time when deflation started, average pressure that stayed in the cuff and us used that data to help to keep accurate pressure in the cuffs for our vented patients.

References

Walston, S. L. (2018). Strategic healthcare management: Planning and execution (2nd ed.). Chicago, IL: Health Administration.

Chapter 15, “Implementing, Monitoring, and Evaluating Strategy” (pp. 339-353)

Behrouzi, F., Shaharoun, A. M., & Ma’aram, A. (2014). Applications of the balanced scorecard for strategic management and performance measurement in the health sector. Australian Health Review, 38(2), 208–217.

Jakob Lauring, Jan Selmer and Annamaria Kubovcikova, Personality in context: effective traits for expatriate managers at different levels, The International Journal of Human Resource Management, 10.1080/09585192.2017.1381137, 30, 6, (1010-1035), (2017)

White, J. (July 6, 2015). 4 keys to reducing patient wait times. https://www.healthcarebusinesstech.com/reduce-patient-wait-times/ 

SAMPLE ANSWER

Group E, Week 3 Discussion

Having a strategic plan for a healthcare institution has become very imperative with the changing healthcare needs. Therefore, it is important for every healthcare institution to have its strategic plan for the future to ensure its success. A strategic plan helps the organization plan for the unknown. This is important to ensure that the healthcare organization can be able to deal with whatever may come along the way that was not expected. One of the most important consideration that needs to be done and planned for is financial requirements for running the organization. An organization should have objectives as well as goals that have been set to be achieved. In order to measure the implementation and success of the set goals, it is important to have a strategic plan. As you have mentioned, it is important for the healthcare organization to have a dashboard that would measure its performance overtime. The dashboard will help in evaluating which areas that may require improvement and which areas that needs to be maintained at the same level. Having a dashboard and a reward system within the healthcare organization can help in improving the efficiency of the organization.

Reference

Strategic Planning in Hospitals. Retrieved from https://www.stratadecision.com/healthcare-and-hospital-strategic-planning/

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Group A Week 3 Discussion

Strategic management is an important management practice in healthcare institutions. Nowadays, in order to achieve improved quality of health services, it is important to set a plan for the future by establishing sustainable processes through a strategic plan. A strategic plan outlines how an organization aims to progress from the current situation to the desire future situation. For the current case, it was important for the board of directors to have done a thorough strategic plan that could have helped them avoid the problems they are currently facing. This would have saved resources as well as costs that can be used to expand the facility. Due to the current situation, the quality of healthcare has been affected leading to patients seeking healthcare services elsewhere. It is important to look at the broad picture while making a strategic plan. This can help in identifying all the elements that can affect positively or negatively a healthcare organization in the future. Hospital performance evaluation is very important in order to determine the performance over time. This in turn would help in the development of a strategic plan.

Week 3 Discussion_Strategic Plan

Reference

Sadeghifar, J., Jafari, M., Tofighi, S., Ravaghi, H and Maleki M. (2015). Strategic Planning, Implementation, and Evaluation Processes in Hospital Systems: A Survey from Iran. Glob J Health Sci, 7(2): 56–65.

 

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Hillsboro County Home Health Agency Strategic Plan

Hillsboro County Home Health Agency Strategic Plan

The strategic planning process is essential for all organizations. Strategic plans help organizations’ Hillsboro County Home Health Agency Strategic Planleaders and stakeholders keep sight of their missions and visions, achieve their goals and objectives, and address their challenges and issues. As a health care leader, you must be able to develop a strategic plan and use it to drive your organizational decision making. For the Final Project, you develop a comprehensive strategic plan to address challenges that have adversely impacted a health care organization.

To prepare:

Review the Hillsboro County Home Health Agency, Inc. (HCHHA) case study in this week’s Learning Resources.

Note: Your Final Project should show effective application of triangulation of content and resources in your conclusion and recommendations.

The Assignment

HCHHA’s board of directors and executive leadership team have asked for your assistance with addressing some of the major issues that have adversely impacted the organization’s financial and operational performances. They have requested that you advise them on the following:

  • Strategies to help the organization address the absence of a Medicare-certified hospice, which has inconvenienced patients and their family members and has led to negative publicity for the organization
  • Strategies that might improve HCHHA’s overall financial performance
  • Strategies that might improve HCHHA’s operational performance
  • Strategies that might assist HCHHA with effectively addressing the various external factors that may potentially threaten its market share

In a 20-page strategic plan, include the following components:

  • Mission statement (provided in the case study)
  • Vision statement
  • Core values
  • SWOT analysis
  • Grand strategies or long-term strategic priorities
  • Operational and tactical plan
  • Key performance and evaluation indicators
  • Change management plan, including the following:
    • The size of the change and its impact on the community and the organization
    • The organization’s readiness for change
    • Change management strategy
    • Team structure and responsibilities
    • Sponsor roles and responsibilities
    • Planning and implementation
    • Communications plan
    • Change management resistance plan
    • Training plan
    • Incentives and celebration of successes
    • Timeline/schedule of activities
    • Budget for change management

The 20-page narrative plan should be written as if it were to be presented to the board of directors. The plan should also include the following pages that will not count toward the 20-page limit:

  • One-page Executive Summary
  • Tables, graphs, and/or charts

The plan should include at least 15 current (no older than 4 years) quality resources, with 10 of those resources being from peer-reviewed sources.

In addition to the paper, you must produce a PowerPoint presentation highlighting the key elements of the paper. The presentation should not be more than 15 slides, excluding the cover slide and the appendices. Be sure to include 100- to 150-word speaker notes to explain the content on each slide.

This Assignment is due by Day 7 of Week 10.  

 

Resources

Walston, S. L. (2018). Strategic healthcare management: Planning and execution (2nd ed.). Chicago, IL: Health Administration.

  • Chapter 13, “Strategic Change Management” (pp. 305-322)

Al-Adwani, A. B. (2014). The extent to which human resources managers in KNPC believe in human resource investment. International Business Research, 7(4), 132–141. Retrieved from http://www.ccsenet.org/journal/index.php/ibr/article/view/31563/20091

Cocks, G. (2014). Optimising pathways for an organisational change management programme. TQM Journal, 26(1), 88–97.

Note: Retrieved from Walden Library databases.

Gopal, S., & Kumar, D. M. (2015). Strategic interventions in tackling poor performance of service departments: Study on Muhibbah engineering. Journal of Economics and Behavioral Studies, 7(4), 6–13. Retrieved from https://www.researchgate.net/publication/281544969_Strategic_Interventions_in_Tackling_Poor_Performance_of_Service_Departments_Study_on_Muhibbah_Engineering_M_Bhd_Malaysia

Henderson, S., Kendall, E., Forday, P., & Cowan, D. (2013). Partnership functioning: A case in point between government, nongovernment, and a university in Australia. Progress in Community Health Partnerships, 7(4), 385–393.

Note: Retrieved from Walden Library databases.

Kash, B. A., Spaulding, A., Johnson, C. E., Gamm, L., & Hulefeld, M. F. (2014). Success factors for strategic change initiatives: A qualitative study of healthcare administrators’ perspectives. Journal of Healthcare Management, 59(1), 65–81.

Note: Retrieved from Walden Library databases.

Martínez-Jerez, F. A. (2014). Rewriting the playbook for corporate partnerships. MIT Sloan Management Review, 55(2), 63–70.

Note: Retrieved from Walden Library databases.

Mutale, W., Stringer, J., Chintu, N., Chilengi, R., Mwanamwenge, M. T., Kasese, N., … Ayles, H. (2014). Application of balanced scorecard in the evaluation of a complex health system intervention: 12 months post intervention findings from the BHOMA intervention: A cluster randomised trial in Zambia. PLoS One, 9(4).

Note: Retrieved from Walden Library databases.

Ovseiko, P. V., Melham, K., Fowler, J., & Buchan, A. M. (2015). Organisational culture and post-merger integration in an academic health centre: A mixed-methods study. BMC Health Services Research, 15, 417–443.

Note: Retrieved from Walden Library databases.

Rajaram, S. S., Grimm, B., Giroux, J., Peck, M., & Ramos, A. (2014). Partnering with American Indian communities in health using methods of strategic collaboration. Progress in Community Health Partnerships, 8(3), 387–395.

Note: Retrieved from Walden Library databases.

Reid, M. F., Brown, L., McNerney, D., & Perri, D. J. (2014). Time to raise the bar on nonprofit strategic planning and implementation. Strategy & Leadership, 42(3), 31–39.

Note: Retrieved from Walden Library databases.

Shea, C. M., Jacobs, S. R., Esserman, D. A., Bruce, K., & Weiner, B. J. (2014). Organizational readiness for implementing change: A psychometric assessment of a new measure. Implementation Science, 9(7), 1–15.

Note: Retrieved from Walden Library databases.

Steinbauer, R., Renn, R. W., Taylor, R. R., & Njoroge, P. K. (2014). Ethical leadership and followers’ moral judgment: The role of followers’ perceived accountability and self-leadership. Journal of Business Ethics, 120(3), 381–392.

Note: Retrieved from Walden Library databases.

Traberg, A., Jacobsen, P., & Duthiers, N. M. (2014). Advancing the use of performance evaluation in health care. Journal of Health Organization and Management, 28(3), 422–436.

Note: Retrieved from Walden Library databases.

Resources for the Final Project

Iedunote (n.d.). Strategic planning process: 9 steps of setting proper strategic plan. Retrieved from https://iedunote.com/strategic-planning-process

Invest-Tech Limited. (2016). Business planning papers: Developing a strategic plan. Retrieved from http://www.planware.org/strategicplan.htm

Queensland Government Chief Information Office. (n.d.). Change management plan workbook and template. Retrieved from http://www.nrm.wa.gov.au/media/10528/change_management_plan_workbook_and_template.pdf

SAMPLE ANSWER

Executive Summary

Hillsboro County Home Health Agency is among the best healthcare providers in the region. In addition to offering quality services to its patients, the agency has massive successes in its main divisions; Home Care Division, Private Duty Division and Community Health Division. However, the facility has been facing challenges that have adversely affected its operations. As such, the board of directors has requested that a strategic plan be designed to address major issues and to improve HCHHA’s financial and operational performance. Additionally, the board of directors has requested that strategies be designed to address the absence of a Medicare –Certified Hospice in the region and what can be done to close the gap. In line with these requests, a strategic plan has been designed. A SWOT analysis has been conducted and grand strategies listed down. Under product development strategies, the plan recommends that HCHHA collaborates with doctors and hospice nurses and other key shareholders to develop a Medicare –certified hospice. To improve market penetration HCHHA should invest in advertisement, expanding its operations to neighboring regions and diversification of products and services. To address the financial problems in the agency, the retrenchment strategy recommends the adoption of the diagnosis related group program system (DRG) to track payments from Medicaid. A tactical plan has been provided that highlights specific goals with fixed deadlines to help the agency develop a Medicare-Certified Hospice facility. Budgets, resources and a marketing plan have also been highlighted. An operational plan is presented where single use plans have been designed to address the high employee turnover rate in the facility. Key performance indicators have been provided that focus on financial metrics, customer metrics, process metrics and people metrics. Lastly, a change management plan has been discussed with key areas highlighted.

Hillsboro County Home Health Agency Strategic Plan

Introduction

The strategic planning process is made up of several steps that effectively use human resources and materials to achieve organizational objectives. The strategy collectively states the purpose of the organization, its mission statement and long-term objectives. Additionally, the strategy develops an appropriate course of action and allocates resources towards the achievement of set strategies (Iedunote). The strategic planning process has nine key steps including; planning awareness, goal formulation, analysis of both the internal the external environments,  identification of threats and strategic opportunities, carrying out a gap analysis, designing alternative strategies, implementing set strategies and measuring progress (Iedunote).  Following these steps, this strategic plan will carry out an initial examination of HCHHA’s state of affairs and develop a plan that will affect daily performance of the organization.

The Hillsboro County Home Health Agency (HCHHA) is among the best health care providers in the country. Founded in 1946 as a nonprofit home health agency, HCHHA has successfully provided quality healthcare services to the people of Hillsboro. However, in recent times, the healthcare facility has struggled with several issues that have negatively affected its financial status and operational performance. As such, the board of directors and the executive leadership team has requested assistance in the development of strategies that;

  • Address the absence of a Medicare-certified hospice resulting in negative publicity for the facility
  • Improve overall financial performance
  • Improve operational performance
  • Address external factors that might negatively affect the facility’s competitive advantage

In line with the aforementioned key areas, this report will provide strategies to help the facility manage the challenges while also maintaining profitability.

Hillsboro County Home Health Agency Strategic Plan

Mission Statement

“The mission of HCHHA is to serve individuals in their usual environments and is concerned with well people as well as people with illness or disabilities. We strive to prevent disease or to retard its progress and to reduce the ill effects of unavoidable disease. We provide quality nursing and therapeutic care to the noninstitutionalized sick and disabled. We also provide information and encouragement to individuals and families, special groups and the community as a whole for the promotion of health”.

Vision Statement

To provide quality healthcare services to every individual in need.

Core Values

  1. To provide patient-centered care
  2. To be a resource center for patients, their families and the community in general
  3. To build good leadership skills
  4. To build and enhance collaboration
  5. To nature professionalism
  6. To offer quality care
  7. To ensure prudent administration of funds

SWOT Analysis

Strengths

  • Good governance
  • Effective community health division at the facility
  • Only Medicare-certified home care service in the county
  • Contracts with managed care organizations
  • Home care division
  • Can-do attitude

Weaknesses

  • Increased dependence on Medicare and other government programs
  • Staff turnover
  • Physician recertification for Medicare patients
  • Lack of employee credentialing and background checks
  • Outdated work rules
  • Lack of Medicare-certified hospice

Opportunities

  • Modernized building
  • Technological advancements
  • Year-round fundraising activities
  • Collaboration with other home health agencies to offer hospice services to the residents of Hillsboro County
  • Increasing market share

Threats

  • Increased competition from other agencies in the home care field
  • Reimbursement changes
  • Increased interest from managed care organizations and insurance companies in the use of home care services
  • Referral of patients living in Jasper to the Capital City Visiting Nurse Association instead of HCHHA
  • Lack of funds
  • Lack of support from United Appeal

Long-term Strategic Priorities

Long-term strategies are corporate level strategies used to identify the organization’s choice with regards to the direction it will follow to achieve set objectives. Setting grand strategies requires the organization to choose a long-term plan from a set of available resources (Silove, 2017). The grand strategies guide the organization’s decision on the allocation of resources from one area of the business to the other and in managing their portfolio efficiently (Silove, 2017). In doing so, the organization chooses the best alternative available. A strategic plan with long term objectives acts as a framework to guide the decision-making process and provide a basis for planning. By analyzing information in a long-term strategic plan, managers are able to make required changes and create a platform for further planning to be done. Thus, a long-term plan is a road map through which a strategic plan will be accomplished.

HCHHA long term plan has the following; product development plan, market growth plan, retrenchment strategies, stability strategies, combination strategies and retrenchment strategies.

Product Development

            A product development strategy is based on the creation of new products or the transformation of already existing products to become new and introducing these products to the market (Kim, Park & Sawng, 2016). Product development strategies are introduced when there is little growth in the company’s current market. In such a state, a company could upgrade an already existing product, evolve a new product or completely abandon the product all together. For many companies, abandoning a product is not economically viable. Therefore, strategies are designed to either upgrade or evolve a product and introduce it into an existing market or into a new market altogether.

After the Middleboro Sentinel news article and the news feature on TV Channel 32, HCHHA has realized the need for a Medicare-certified hospice. The lack of a hospice in Middleboro has prompted HCHHA to develop strategies to address this need. In line with this objective, HCHHA has engaged the services of a consultant to estimate the need for a Medicare-certified hospice in Hillsboro County. This hospice facility is a new product that HCHHA is intending to introduce into the market. According to Kim, Park and Sawng (2016), a new product can be defined as a product in which a company introduces to a new market and in which changes are conveyed. New product development process involves the formalization of planning and thoughts from the initial stage of generating ideas to the last stage of market launching. This product development strategy for a new Medicare-certified Hospice will highlight seven key phases of; idea discovery, idea screening, concept development, business analysis, developing a mix between marketing and the product, market testing and product launch.

New product development projects often fail during the early stages of development or in the last stage of product launch phase. The underlying causes of failure often occur in the initial stage of product development (Floren, Frishammar, Parida & Wincent, 2018). Managing the front end of the new product development process has significant implications on product success. Based on the consultant’s report, over 55% of individuals who have cancer seek the services of a hospice. Additionally, most hospice care is offered to individuals at their home. With 85% of individuals who seek Medicare-certified hospice care being fully covered by Medicare, the need for a HCHHA hospice care is long overdue. Due to lack of physical space, HCHHA can opt to offer these services at the patient’s home. Hospice care is designed to offer care for 24 hours a day, 7 days a week (Meier, 2015). By coordinating with doctors, hospital social workers, case managers and discharge planners, a HCHHA Medicare-funded hospice is a possible new product.

Hillsboro County Home Health Agency Strategic Plan

Market Growth

Most organizations have plans to grow their business and increase sales. As such, market growth strategies are necessary to facilitate this growth. There are several growth strategies that organizations can employ. They include; market development, market penetration, product expansion and diversification (Boag & Dastmalchian, 2015). Growth under market penetration attempts to increase an organization’s market share using current products and services. HCHHA has several programs that it offers to residents of Hillsboro County and beyond. The private duty division and the community health division have several programs that offer a wide range of services including high blood pressure screening programs, senior health clinics, personal care services, head lice program and senior health clinics. Recently, there have been increased referrals to Capital City Visiting Nurse Association instead of HCHHA. To improve market penetration, HCHHA can increase its marketing efforts by placing adverts in the local dailies and TV stations.

Achieving growth requires several strategies that increase profitability and success. Market development involves introducing products and services to new markets. HCHHA is a reputable facility known to offer quality care to residents of Hillsboro County. With this in mind, the facility should invest in expanding its business to neighboring counties. Diversification on the other hand, involves creating a completely new product for a new market (Liabotis, 2017). This strategy is the most uncertain making it the riskiest strategy yet. By venturing into the hospice business, HCHHA risks failing and the same time, the possibility of reaping high benefits is also present. Overall, for HCHHA to increase its value, it must invest in the aforementioned growth strategies.

To achieve growth, HCHHA should strengthen their infrastructure to ensure that it is up to standards to support successful execution (Liabotis, 2017). HCHHA has already invested resources to renovate Middleboro office in the Hartsdale House by installing new sprinkler systems and fire warning systems. It is recommended that the facility utilizes performance drivers that align with the growth strategy. Additionally, the facility could grow more leaders at both managerial and non-managerial levels of the organization.

Hillsboro County Home Health Agency Strategic Plan

Retrenchment Strategy

            Retrenchment strategies seek to divest, restructure or sell a business unit with the purpose of reducing costs, streamlining operations and stabilizing cash flow. There are three primary retrenchment strategies; turnaround strategy, divestment and liquidation strategies 9Casillas, Moreno-Menendez, Barbero & Clinton, 2018). The turnaround strategy requires the realignment of operations to be more profitable. Often, turnaround strategies are designed as a response to ineffective strategies causing harm to the organization. HCHHA has financial issues both in the private duty division and the community health division. The home care division is fully funded by Medicare and Medicaid. However, the facility is receiving less money per patient that what Medicare allocates to other facilities. It is recommended that HCHHA adopts the diagnosis-related group (DRG) payment system to track payments from Medicare and other private health insurance companies. When the facility treats a patient, they should assign a DRG when the patient is discharged. The facility is paid a fixed amount for the DRG regardless of the amount of money it spent in the patient. If the facility effectively treats a patient for less money than what Medicare pays for the DRG, the facility is able to make money on that hospitalization (Davis, 2019).

Divestment strategies involve reducing operations or getting rid of a business unit. These strategies are often implemented when a business unit is losing money or when it does not fit with the company’s core objectives. Divestment strategies require the facility to allocate resources to other profitable business units (Casillas et al. 2018). Recently, HCHHA staff nurses have expressed their concern on the extra time it takes to do paperwork from home after work. This in turn reduces productivity and increases costs. It is recommended that HCHHA employs data clerks to help staff members file paperwork.

Hillsboro County Home Health Agency Strategic Plan

Liquidation strategies are similar to divestment strategies. Liquidation focuses on shutting down units and selling specific assets (Casillas et al. 2018). With the unstable Medicare reimbursement system, HCHHA should consider selling some of its divisions to other local hospitals to mitigate losses.

Stability Strategy

Stability strategies seek to maintain operations in a business. These strategies are characteristic of organizations that are comfortable with their current positions. Some of the strategies include; no change strategies, profit strategies and caution strategies (Alshawabkeh et al. 2019). No change strategies are used when an organization makes no changes to its operations. The organization examines factors affecting its market environment and decides to maintain its strategic objectives. HCHHA at the moment has a positive rapport with its customers. Therefore, it should continue to stay unaffiliated with other hospitals in the region. Profit strategies are used to improve profitability. Profit strategies may include; increasing output, raising prices or offsetting losses. It is recommended that HCHHA should boost its home visits to boost productivity. According to board member David Ruseski, staff productivity should be increased. Thus, the Home Health Visit Staff Productivity Profiles for RN, LPN, HC aide, Physical therapists, occupational therapists and social workers should be implemented at the facility. Caution strategies on the hand, require organizations to wait and assess the market before employing new strategies. These strategies are considered to be reconnaissance and are conducted before any strategic action is taken (Alshawabkeh et al. 2019). In line with this objective, HCHHA should first assess the market for Medicaid-funded hospice services before embarking into this venture. Stability strategies are used to maintain an organization’s position in the market.

Combination Strategy

            Combination strategies are used to combine several master strategies. Combination strategies may include the use of different strategies in each business unit. Additionally, the strategies may include the use of multiple strategies in individual business units at the same time or during different occasions (Parnell, 2014). Thus, combination strategies are designed to mix growth strategies, retrenchment strategies and stability strategies. It is recommended that HCHHA continues to consolidate its position in the existing business of home care while also entering new areas like the hospice home care services.

Hillsboro County Home Health Agency Strategic Plan

            When businesses experience deteriorating performance due to market erosion, they respond by selecting strategies that redirect attempts to turnaround its operations and improve its competitive position (Casillas et al. 2018). One form of retrenchment strategies is a turnaround strategy that focuses on operational improvement. When organizations adopt retrenchment strategies, they reduce one or more business operations with the aim of cutting expenses to reach a stable financial position. In addition to turnaround strategies, businesses can either adopt divestment strategies or liquidation strategies (Casillas et al. 2018). HCHHA may consider charging customers who seek their Telehealth program instead of offering the service for free. If this venture proves difficult, HCHHA should shut it down.

Operational and Tactical Plan

Tactical Plan

A tactical plan describes tactics that an organization plans to implement to achieve what is outlined in the strategic plan. Tactical plans are short range, with a scope of one year or less. Tactical plans are flexible and are designed to achieve the organization’s goals and objectives (“Strategic Planning”, 2014). The following are important components of a tactical plan

Specific Goals with Fixed Deadlines

  • Open a Medicare-funded hospice division within ten months
  • Adopt a Diagnosis-related group payment system (DRG) within three months
  • Hire data clerks to help home care nurses with paper work in a month
  • Increase staff profitability by reducing travel time to and fro patient’s houses within two months
  • Conduct benchmarking activities on other hospice facilities to determine viability and opportunity for growth within the next six months
  • Adopt performance drivers to grow more leaders in the facility and to reduce employee turnover rates within the next year
  • Modernize the Middleboro office by adding fire alarm systems and sprinkler system within four months

Hillsboro County Home Health Agency Strategic Plan

Budgets

A majority of the funding or revenue inflow for the strategic plan will come from fundraising activities and grants. Additionally, funds will be obtained from the 960,000 USD bequest given to the facility by a former patient. A budget will be allocated for hiring new data clerks. Additionally, a budget will be allocated for marketing campaigns in the local newspapers and TV stations.

Resources

The resources that are required to achieve the organization’s aims include; human resources and cash resources. HCHHA will continue contracting the services of a private duty nurse, Amy Edwards, RN and her associates who conduct in-home IV therapy. This is in line with the facility’s mission of providing quality care to patients. With word going around that Rock Creek, a private long-term care facility in Mifflenville is developing plans to start a private home care agency, HCHHA risks losing some of its clients to Rock Creek. As such, a majority of the cash resources should be directed towards advertisements to reassure customers of HCHHA quality services.

Marketing

HCHHA will create an affiliate program to improve its marketing strategy. Additionally, due to the financial constraints, HCHHA will use growth hacking to combine creativity, social metrics and analytical thinking to sell the facility’s services. Referrals programs will form a large portion of the marketing for the facility. Clients will be incentivized to tell others about the services offered at HCHHA. In addition to using traditional methods of advertising, HCHHA will use earned media or free media to facilitate inbound marketing and to increase awareness of the services offered at the facility. Lastly, HCHHA will use content marketing which emphasizes on education rather than selling to influence the buying behavior.

Operational Plan

            An operational plan describes daily activities in the running of a business. It provides a roadmap for achieving tactical goals within realistic frameworks. An operational plan is highly specific with emphasis placed on the achievement of short-term objectives (“Strategic Planning”, 2014). Operational plans are divided into single use plans and ongoing.

            Single Use Plans

Single use plans are created for single occurrences and are highly specific (“Strategic Planning”, 2014). According to Catherine Newfields, the home care division manager, there has been high employee turnover and a reluctance of staff to provide all round IV therapy to cancer patients. A recruitment drive to hire new employees is an effective single use plan that the facility can adopt.

            Ongoing Plans

Ongoing plans focus on policies, rules and procedures and are created on an ongoing basis. Policies are used to dictate how managers approach situations. Policies also decision-making processes in the organization. Rules on the other hand are regulations designed to help organizations function. Rules are hard coded and are enforced stringently while procedures are step-by-step processes that accomplish specific objectives (“Strategic Planning”, 2014). HCHHA should therefore develop ongoing plans that include termination of contracts, hiring new employees and sourcing for medical equipment among other tasks.

Hillsboro County Home Health Agency Strategic Plan

Key Performance and Evaluation Indicators

Key performance indicators (KPI) are performance measurements that institutions use to gauge how they are performing. KPIs act as compasses helping organizations understand whether they are taking the right path towards their strategic goals (Jahangirian, Taylor, Young & Robinson, 2017). To be effective, KPIs must be quantifiable, well-defined, must be communicated throughout the organization and its departments, must be crucial to achieving strategic goals and must be applicable to the organization’s line of business (Jahangirian et al. 2017). For HCHHA, the key performance indicators that will be used include; financial metrics, customer metrics, process metrics and people metrics.

Financial Metrics

  1. Profit: gross and net profit margins will be analyzed to understand how successful the organization is at generating high returns.
  2. Cost: cost effectiveness of the proposed interventions will be analyzed to determine ideal ways of reducing and managing costs
  3. Line of business revenue Vs. Target: HCHHA’s actual revenue will be compared with its projected revenue. Discrepancies will be charted and analyzed to help management identify departments that are performing better than others.
  4. Cost of services offered: the production costs of the services offered by the home care division, private duty division and community health division at HCHHA will be tallied. This will help the facility get a better idea of its profit margin. This information will be used to determine how to outsell its competition.
  5. Line of Business (LOB) Expenses Vs Budget: The actual overhead with the forecasted budget will be compared. This will help the facility understand where it deviated from the plan to help the facility created effective departmental budgets in the future.

Customer Metrics

  1. Customer Lifetime Value (CLV): CVL will help the facility understand the long-term value of maintaining customer relationships. This indicator will be used to identify the best channel to use to gain customers for the best price.
  2. Customer Acquisition Cost (CAC): this indicator will help HCHHA evaluate the cost effectiveness of its marketing campaigns
  3. Customer satisfaction and retention: the facility can use customer satisfaction scores and percentage of return customers to gauge customer satisfaction levels.
  4. Net Promoter Score (NPS): the facility can determine its NPS by sending quarterly to customers to gauge the likelihood of them referring the facility to other patients. By establishing a baseline, strategies can be put in place to help the numbers grow.
  5. Number of customers: the organization can determine the number of customers it has gained or lost to determine whether the consumer’s needs are met.

Process Metrics

  1. LOB Efficiency Measure: efficiency can be measured by analyzing the number of patients that HCHHA meets in a day and the percentage of time the facility was operational.

People Metrics

  1. Employee Turnover Rate (ETR): HCHHA will calculate its ETR and if it is high, the facility should examine its workplace culture, work environment and employment packages to determine areas of change.
  2. Employee Satisfaction: the facility will use surveys to measure employee satisfaction. The information obtained will be used to gauge organizational health.

Change Management Plan

The change management process follows a sequence of steps that a change management team will apply to a change to drive individual transition and ensure that the organization meets its intended outcomes (Malek & Yazdanifard, 2014). There are several key elements that guarantee a successful change management process. Change management plans on the other hand, are designed to support a project until it delivers change. HCHHA like other organizations is consistently going through change. The development of a new Medicare-funded hospice division is one example of change. In line with this, a change management plan is essential as it minimizes the impact of change on the organization and staff.

Size of the Change

            In the recent past, there has been concern over the lack of a Medicare-Certified hospice facility in Middleboro. HCHHA as a home health agency is tasked with the responsibility of providing hospice care to the terminally ill in the town. This need has prompted HCHHA to engage consultants to estimate the need for a Medicare-Certified hospice in Hillsboro. A hospice will provide much needed home care to the terminally ill in the community. HCHHA will need to hire new staff members who are well trained in hospice care. Financial resources must be directed towards providing infrastructure to facilitate the creation of a hospice facility. The change management team will be assessed before the plan is designed. Additionally, every team member will be allocated specific tasks and areas of the project. Rules will also be created to control the change management process. The rules will provide a guideline on how teams are chosen, how team members are assigned tasks and how everyone will be held accountable for their actions. Project completion objectives will also be set.

Hillsboro County Home Health Agency Strategic Plan

Readiness for Change Assessment

Readiness assessments are used by the change management team to assess the organization’s readiness to change. The assessment provides the project team with insights into opportunities and challenges that the project might face during the change process (Weiner, 2014). The readiness for change assessment will provide; the scope of the change in terms of the department that will be affected, number of employees impacted by the change, type of change and amount of change that has currently been done.

The first step in the readiness assessment is the data collection step. Data will be collected using both qualitative and quantitative methods. Qualitative data will be collected by conducting interviews with key stakeholders (Weiner, 2014). This will involve individuals in the leadership position and other staff members directly involved in the hospice project. Additionally, internal organizational influencers will be included. During the interviews, several outcomes will be analyzed; the level of understanding of the project, the level of understanding of the benefits and barriers that the project will face, understanding of the project’s vision and mission, an appreciation of the organization’s need for change. Quantitative data will be collected via the distribution of a readiness survey (Weiner, 2014). The survey will be distributed to the leadership team, the project team and the end users. The survey will ask questions around project sponsorship, resources, support and understanding the change. The data collected is analyzed to gauge readiness for change and to tailor communications that target specific departments. Lastly, recommendations are made to improve project understanding and competency.

Change Management Strategy

Change management strategies are used to highlight specific ways in which organizations address change. The first step in the change management strategy involves urgency creation. Change will only be successful if the entire staff at HCHHA wants it. By creating awareness around the program, staff members at the facility will receive the idea well (Jalagat, 2016). Awareness will be created through the use of statistics and visual presentations to convey the benefits of offering hospice services. In addition to creating awareness for the project, a team will be selected to carry out the change. The team will be organized and responsibilities assigned to each member. Creating a vision for the change process is essential as it makes everything clear to all parties involved. Additionally, a clear vision will help the project implementation team better perform their duties. The vision derived must then be communicated to the rest of the staff members (Jalagat, 2016). The project’s vision should be communicated frequently. Obstacles to change are expected. Therefore, strategies to remove obstacles should be created to increase the team’s morale. To avoid failure, the project team should refrain from declaring victory early. Instead, the team should let the change mature. Lastly, mechanisms should be created to integrate the change into the organization’s culture.

Team Structure and Responsibilities

The main purpose of change teams is to effect change. Thus, a change management team is vital to the health of this change program (By, Kuipers & Procter, 2018). Before selecting a change team, their roles and responsibilities must be determined. Responsibilities revolve around the problem being solved by the change project, the task being executed and the change model already in place. The change model implemented will be used to determine; the change model, the organization structure and budgetary constraints. The HCHHA change will comprise of; change leaders, change managers and change agents. The role of the change leader is to create the vision for change and to drive the change itself (By, Kuipers & Procter, 2018). Therefore, the change leader acts as the impetus that propels the change forward. The change manager will oversee and administer change initiatives. Change agents are tasked with the responsibility of enacting the change. Prosci’s change team structure will be used to provide a step-by-step guide for mapping out and enhancing change. The framework has five key roles for the change management team, executives and senior managers, supervisors and managers, the project team and project support functions. Overall, the team makeup is crucial in ensuring the success of the change management initiative.

Hillsboro County Home Health Agency Strategic Plan

Sponsor Roles and Responsibilities

            Involving leaders to effect change is not enough, change initiatives need sponsorships. Sponsors help the project allocate resources, acquire critical stakeholders, resolve conflicts, provide leadership and needed support to effect change. In line with this, sponsorship is essential to guaranteeing success in organizations’ change management strategies (Helm & Remington, 2015). Sponsors introduce leadership and new information to projects so that project teams can work efficiently. Additionally, sponsors provide resources and eliminate potential roadblocks to change. Leaders have the responsibility for providing budgets and resources to help the project move forward. Good sponsors provide the team with what they need currently and what they might need in the future. Sponsors create alignment, improve communication channels and use their influence to shape and reinforce behavior. Good sponsors unite people and helps them work through roadblocks and move towards productive agreements (Helm & Remington, 2015). Sponsors also demonstrate a sense of commitment to their roles and to their project success. Lastly, sponsors work towards achieving sustainable change during the course of the project and beyond it.

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The HCHHA hospice project will be sponsored by grant holders. The finance committee will oversee budget implementation and will examine budget variances. Additionally, resources will be obtained from the 960,000 USD restricted bequest that HCHHA received from a former patient.

Planning and Implementation

Management support is essential in improving employee comfort levels during change implementation. A case for change should be created from different sources. Data should be collected from customer satisfaction surveys, employee satisfaction surveys, business goals and strategic planning (Cocks, 2014). The data should then be used o identify the best ways to identify and justify areas that need improvement. Change efforts should incorporate employees at all levels. Any change should be effectively communicated and explained to all employees. Communication should be structured and systematic to minimize resistance and improve inclusion. Once a change has been planned, effective communication is necessary to facilitate the implementation stage (Cocks, 2014). A timeline should be made to allow for appropriate resources and training to take place before the change is fully implemented. Without a logical order, the implementation process can create frustration for the shareholders. Whenever a change is introduced, a follow-up must be done after the implementation process to assess if the change delivered the results intended. If the desired results are not achieved, adjustments should be made until the desired results are achieved. Change implementation often encounters barriers. Barriers may come from other employees, organizational departments, lack of training or lack of equipment. Management should ensure that these barriers are dealt with (Cocks, 2014). Lastly, management should celebrate the success of small changes as they happen to build momentum for bigger changes.

Communications Plan

A communication plan is a crucial part of every organization’s management toolkit. With a communication plan in place, the management will be better placed to announce changes in the organization. An effective communication plan should have an audience analysis. An audience analysis requires management to separate the management group and the employee group to ensure that a more tailored communication is delivered (Newman, 2016). Once the audience has been identified, tailored questions will be created to better understand the audience. In addition to conducting an audience analysis, communication objectives should be set to address each audience. The objectives might be broad, for HCHHA, the broad objective will be to develop a Medicare-certified hospice in Hillsboro. The objectives should then be narrowed down to become more specific. Afterwards, communication channels should be selected based on the best ways to reach the audiences (Newman, 2016). Using a variety of communication channels including written and oral communication increases the odds of success. Responsibilities should also be assigned to every member of the communication team to determine who writes and who delivers the messages. Message timing is also important to a well-constructed communication plan. Lastly, during a change process, messages should be appropriately sequenced and closely tied to guarantee maximum output (Newman, 2016). Therefore, timing and frequency of messages should be determined.

Hillsboro County Home Health Agency Strategic Plan

Change Management Resistance Plan

One of the most recalcitrant problems that many changes management team face is employee resistance to change. Resistance takes a number of forms including chronic quarrels, strikes, requests for transfers or other pseudological reasons why the change might not work (Marrewijk, 2018). To avoid forcing change on employees, strategies should be put in place. Getting employees involved in the change will help management avoid resistance. Additionally, by understanding the true nature of resistance will reduce friction. Resistance is usually as a result of blind spots and attitudes that many employees have as a result of their preoccupation with technical factors associated with new ideas (Marrewijk, 2018). Knowing this, the change management team can take concrete steps to address staff attitudes. This includes emphasizing appropriate standards of performance and encouraging staff to think differently and accept change. Top executives should also make their efforts effective during meetings with other employees and in change management groups where change is being discussed. This will increase receptiveness to change. Additionally, creating win-win situations will make it easy for resistant employees to participate in the change (Marrewijk, 2018). A majority of resistance to change can be avoided if efficient change management is applied at the beginning of each change project. This can be achieved by utilizing a structured change management approach at the beginning of the project. Senior leaders should also be engaged as sponsors. Likewise, every employee at all levels of management should be engaged as advocates of change (Marrewijk, 2018). Lastly, resistance can be avoided by communicating the need for change, the impact the change will have on the employees and the benefits the change will bring to the organization as a whole.

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