Nursing Leadership Final Project Education for Better Patient Outcome

Nursing Leadership Final Project: Education for better patient outcome Questionnaire/interview answered by the nurse leader. 1. What is the expected change or improvement? Improved patient and caregiver education to achieve 100% of the education by the end of the year. 2. Do you believe that the change would lead to improved patient outcomes and quality of care? Yes, that is exactly what the improvement or change is expected to achieve. To ensure the overall quality and safety of care of our rehabilitation and long term care patients is key among our main objectives at the hospital. The improvement of patient safety and care can, therefore, be achieved through better education of the patients and the caregivers. 3. What about the staff acceptance and adherence to the change. Will there be any resistance? Resistance to change exists in all organizations, but it is all about the management of the staff and the type of leadership used. I believe that if in engage all the staff, including the staff, that is not professional such as cleaners, to ensure that they are all on board with what we set to achieve through the change. It is true the change would require increased work from the staff but by involving them in some of the decision makings, we are set to reduce resistance to change. 4. What is the organization doing currently on the aspect of patient education? Our staff is working day and night with many hours of patient education with only one session per month, and this has led us to achieve a 60% education rate. 5. What process do you plan to implement to achieve the intended targets? The process entails increasing the patient and caregiver education from one session after rehabilitation to three sessions per month, with some of the sessions even taking place in the patients' place of residence. 6. Finally, what are the expected outcomes? We are set to achieve 100% patient education at the end of the year, through this, there will be assured improved patient safety and care, and thus reduced mortality rates of the patients we have treated. 7. Provide an estimated cost for the change The change is expected to be expensive, and that is not new. However, that is what is expected with changes in healthcare. The increase in expense will, however, be catered for by the insurance policies and the patients. The cost is, however, expected to be high only during the first year at about 2 million USD, but the subsequent years the allocation towards the program is expected to be 1 million USD. Figure 1: Donabedian model to illustrate interview question 4,5, and 6 I had a wonderful experience during my clinical hours with my preceptor, who was very much willing to teach and share his experience. It was an outpatient urology department where they do many rehabilitation and long term care procedures. The nurse leader I followed had about 80 nurses under his management including patient care technicians. Things are a little different in this particular hospital compared to others. From what I have noticed and learned from those hours spent with my preceptor is that many things are managed through online communication via emails and setting up appointments. I got to see the different leadership styles in my preceptor. We talked about it in our discussion as well as one to one conversation. Autocratic leadership is used at one point when there was a problem with desk space as there was not enough space for the nurses and other health care professionals. In this situation, the nurse leader/manager had to make a decision on his own and use his power because this was one issue that has been in existence for so long, and everybody needs desk space. On the other hand, he uses mostly democratic leadership by asking the opinions of the other employees and has a friendly relationship with all the coworkers. Overall, it was a great experience and I enjoyed my clinical hours at this facility. PDSA There is a need to improve the quality of patient safety and care at the facility through the improvement of processes and outcomes. The increase of patient and home caregiver education visits before and after rehabilitation to three per month to ensure that 100% of the eligible patients are educated within the next one year. The PDSA cycle would be used in achieving this, and it has four phases including the Plan, Do, Study, and Act phases (Hughes, 2008). The Plan Phase Planning is essential, but it is first important to determine what is set to be accomplished. Which is the increase of patient and home caregiver education visits before and after rehabilitation to three to ensure that 100% of the eligible patients are educated within the next one year. The first issue involved in planning is team formation, where the relevant stakeholders needed for effective planning are gathered (Hughes, 2008). The members of the senior leaders need to be part of this team and thus, the nurse leader becomes the overall team leader. Additional members involve those departments that can affect the success of the change; in this case, a pharmacist can aid in educating the patients on the best drugs to use in case of any side effects and drugs not to use. Overall, the team will be made up of the hospital CEO, nurse leader, nurses, pharmacists, and physicians. It is important to ask what and why and what question is answered through the outcome and process merits. The outcome is increased cancer patient safety and quality care. The process is through increasing patient education visits before and after rehabilitation to three per month to ensure that 100% of the eligible patients are educated within the next one year, and this is expected to be maintained at the high levels. The sessions should be available at both the hospital and home visits will also be introduced to minimize patient travels (Evans et al., 2014). The reasons for improved processes and patient safety outcomes include better patient care, improved patient safety, and increased efficiency. These reasons are despite that it may lead to additional costs but this will be catered for through insurance and from the patients’ pockets. The Do Phase The do phase is essential since, after the process of planning, it is important to implement what has been planned. The education of staff and effective communication processes are essential for the improvement of patient education (Hughes, 2008). It is essential to ensure that critical patients that need education are identified through the criteria so that the increase in patient education is started on the. Patients are reminded of educational visits through phone calls and other modes of communication. Then it is essential to follow up on patients that do not come to the visits so that they can be visited at their homes. The outcome determines the process metrics, with the outcome being improved patient safety by targeting 100% education through increased patient and caregiver education sessions. The process metric is to increase patient education visits before and after rehabilitation to three every month to ensure that 100% of the eligible patients and caregivers are educated within the next one year. Without the process metric, it would be hard to ensure that 100% patient and caregiver education is achieved. The implementation, however, entails staff education, and communicating to the staff is vital to the success of the improvement plan. Situation, background, assessment, and recommendation (SBAR) tool can be used in the process of staff communication (Hughes, 2008), as shown in the table below. SITUATION On 2nd January 2020, the hospital will start the annual target of achieving 100% patient education through increasing patient education sessions to three per month. BACKGROUND Patient education of cancer patients is essential in improving patient safety and ensuring that caregivers provide quality care to these patients at home. ASSESSMENT The purpose of this improved measure is to help reduce the number of deaths and hospitalizations related to poor care of cancer patients, especially rehabilitation side effects through improved education of the caregivers and the patients themselves (Evans et al., 2014). Through patient education at our facility is good; only 60% of our patients were educated according to statistics. We have developed a team of leaders and peers that examined the data and thus put in place this plan. RECOMMENDATION Start the new educational sessions and processes at both the hospital and the patients’ homes or places of residence on 2nd January 2020. A form or checklist will be developed to be used in the process of assessment. Report any daily huddles and deficiencies. Table 1: SBAR Communication for the Improvement The Study Phase The study phase entails the selected team evaluating patient and caregiver education data and determines if the change in the process is essential for reaching the outcomes effectively. It is essential for timely decision-making. Important ways that process data can be measured and monitored include the use of audits, direct observations, and checklists. Collection, reporting, and analysis of data in a concurrent manner leads to massive improvements to the quality of performance as it also prevents errors from reaching the patients, thus ensuring patient safety. The Act Phase Any changes in the initial plan are implemented at this phase, especially after data from the study phase shows any expected changes (Hughes, 2008). Examples of initiatives that can be conducted in this phase may include additions to the education of staff and other methods to ensure that staff accountability and ownership of the changes are implemented. The representation of the change using the PDSA cycle is represented in the figure below. PLAN Team formation. Outcome and process merits. ACT Any changes in the initial plan are implemented at this phase. Additions to the education of staff is an example. DO Staff education. Visiting the patients a home Reminding patients of educational visi vi STUDY Evaluating patient and caregiver education data. Collection, reporting and analysis of data in a concurrent manner.