Describe the behaviors of leadership and the role of leadership in implementing these strategies for change within the organization.

1. Quality Outcomes: What are the desired quality outcomes you hope to achieve through implementation of your initiative? Your outcomes should be reasonable, measurable, and time-considerate to help monitor progress. 2. Communication: Analyze the organizational processes for communicating change initiatives to determine the most effective paths/methods for promoting the proposed initiative. 3. Data Flow: Discuss how the existing organizational processes will allow for improved or maintained flow of survey-required quality data that may be valuable for tracking your initiative. 4. Needed Leadership: Describe the behaviors of leadership and the role of leadership in implementing these strategies for change within the organization. In other words, what responsibilities do leaders within your organization hold to ensure the implementation of the initiative? Guidelines for Submission: This paper should be 23 pages, not including the cover page or reference page. APA format is to be used for the reference list and all internal citations (at least three evidence-based sources are required). This milestong (3), continues from milestones 1 thru 2 MILESTONE 2: Evidence-Based Practice Literature Review Proposal Care Support Based on the available literature body, this proposal identifies the importance of identifiable information about patients to the development of health care practice at St. Catherines Community Hospital. There are circumstances in the hospital setting that allows for the sharing of identifiable patient information used for their treatment (McCarty et al 2018 p280). As opposed to the common practice, there is need for the protection of the doctors and nurses access to the patients medical information, in order to promote uninterrupted service from and with other departments. The care providers have been assigned the duty to offer health care protection and supervision to the elderly patients. For this reason, the hospital administration is responsible for the protection of patient information, and how it is used in patient care. Value-based Support There is need for the health organization to make an appropriate shift in the medical care setting in order to improve the quality of service it offers to patients. For instance, the current delivery of service in the hospital is mainly based on the fee-for-service method of treatment. Hence, major studies have focused on the transformational shift from this way of treatment to newer ways of managing and finding solutions to patient care. For instance, Chereen Langrill, 2017, describes prevention as the primary approach under value-based care since it helps in the coordination of medical processes (Langrill, 2017). Primarily, other sources of study also incorporate the reframing and expansion of value-based care in a way that can help the hospital to improve the patients access to hospital resources in order to enhance a healthier lifestyle in the hospital setting during treatment. Data evidence A report by Rich Kirchen, 2016, indicates that St. Catherines Community Hospital has already planned for the construction of an outpatient surgical wing (Kirchen, 2016). Additionally, the hospital had also proposed a United Hospital System, through a new project that is expected to increase the number of preoperative suites including a minimum of eight recovery areas and surgical rooms. This form of service expansion is a clear-cut upgrade to the hospitals services and the ultimate competition with other nearby health care facilities (Kirchen, 2016). Therefore, the United Hospital System and other major upgrades to the hospitals communication system will help in maintaining and enhancing the medical room services, eventually promoting the outcome of patient safety. Strategies A risk research was done by Catherine A. McCarthy et al, 2017, through the use of evidence-based fall-risk assessment as well as interventions for care delivery in the elderly patient care setting (McCarty et al, 2017 p281). From the study, the fall-risk assessment is considered an appropriate intervention that is primarily effective at St. Catherines Community Hospital. This proposal identifies the short-term and long-term issues encountered when using the fall-risk assessment and intervention, mainly intended to decrease the number of patient falls in the hospital (McCarty et al, 2017 p282). Generally, the long-term outcome of this intervention is measured over a period of time, and this outcome is expected to have a significant impact on the improvement of evidence-based treatment within the medical rooms. Strategy Defense This literature review also reports on the effectiveness of the fall-risk assessment as a way of enhancing patient safety within the hospital setting. A trial study by McCarthy et al, 2017, indicates that the implementation of this intervention in an emergency department resulted in a smaller number of patients that were left unchecked for their falling risk (McCarty et al, 2017 p283). For the current study, the assessment provides a framework for the implementation of an evidence-based approach of improving patient safety. Change Theory Richard P. Grol et al, 2007, suggest an excellent development of a unifying model of planning and implementing a change intervention that is applicable in the perspective of St. Catherines Community Hospital (Grol et al, 2007 p94). Their study mainly evaluates the process theories of change in the health care setting as they pertain to the effectiveness of planning and organization of different activities such as communication within the hospital setting. Based on this information, the hospital has an opportunity of influencing the outcomes of the patient conditions since they are the target group by these activities. Therefore, the scientific principles of the process theories such as changing practice routine, attention towards the specific innovation and the commitment of the target group etc., provide a model for the hospital to implement the new health care plan effectively. Change Assessment The changes implementation on the hospitals practice routines need to be considered deeply based on the complexity that accompany the provision of care to adult patients especially above 65 years of age. Grol et al, 2007, suggest that the implementation of this approach can best be achieved by taking all the relevant health care measures into consideration (Grol et al, 2007 p95). A well-planned approach in the implementation of the change to the hospital setting also requires the commitment of the target group (professionals or teams in the hospital) who will receive this proposal for changing their performance. Eventually, a successful implementation of the change requires greater attention of the hospital administration to the scientific basis, as well as the ultimate form through which it is presented. The hospital is required to follow the particular innovation characteristics of this change if they intend to achieve and promote its adoption successfully. ? References Grol, R. P., Bosch, M. C., Hulscher, M. E., Eccles, M. P., & Wensing, M. (2007). Planning and studying improvement in patient care: the use of theoretical perspectives. The Milbank Quarterly, 85(1), 93-138. Retrieved July 28, 2018, from Kirchen, R. (2016, October 11). St. Catherine’s Medical Center plans major expansion for advanced outpatient surgery – Milwaukee – Milwaukee Business Journal. Retrieved July 28, 2018, from Langrill, C. (2017, September 12). Value Based Care. St. Lukes. Retrieved July 28, 2018, from McCarty, C. A., Woehrle, T. A., Waring, S. C., Taran, A. M., & Kitch, L. A. (2018). Implementation of the MEDFRAT to Promote Quality Care and Decrease Falls in Community Hospital Emergency Rooms. Journal of Emergency Nursing, 44(3), 280-284. Retrieved July 28, 2018, from MILESTONE 1: Organization St. Catherines Community Hospital is a private healthcare facility that specializes in the elderly care. The hospital serves the southeastern geographical location of the United States and it is accredited by the Joint Commission on Accreditation of Hospitals in the country. The hospital is among few exclusive specialties for the elderly in the US. The hospital’s values include respect, equity, service, healthcare enlightening, provision of high-quality standards, safe and cost-effective care. St. Catherines Community Hospital is guided by five great healthcare managements which facilitates effective delivery of medical care to the elderly within the community. The healthcare practitioners are well coordinated and work together in an innovative and brilliant manner. The first management strategy utilized by the healthcare facility is transparency. The hospital has managed to maintain transparency through the development of an information system that allows the elderly patients to post their comments, complaints, and recommendations as well as their satisfaction level of the services delivered to them. The comments presented are usually open to the public to help build up trust and enhance transparency and accountability. The hospital also has a culture of sharing responsibilities enhancing coordination and fast delivery of patient care. The physicians are also committed to helping out whenever they can even outside their specialty and they also assist in delivering care in the event that one of them is late. Moreover, the hospital is defined by teamwork as addresses the socioeconomic issues affecting the elderly in the society as well as in the organization. These approaches have enabled the healthcare facility to offer continuous and reliable health care to old people of 65 years and above in the Southeastern part of the United States. Improvement opportunity According to a study by Aase, Laugaland, Dyrstad, Storm (2013) the elderly in the society are vulnerable with regard to safety and financial issues. This is evident in increased falls in the hospital settings as well increased deterioration of health particularly due to lack of proper care in their homes. These results from the lack of financial resources to provide a healthy diet, physical exercises, health check-ups as well as good living conditions that prevent falls. Apparently, falls and lifestyle diseases are common in the hospitals offering healthcare to the aged in the society. As such, these organizations face challenges while tending to these people due to the financial constraints associated with their conditions. For instance, fall patients tend to experience falls even in the health facility and therefore demand frequent attention from physicians which increases the demand for care providers and development of facilities with designs that discourage falling. On the other hand, these patients are occasionally unable to raise the high hospital bills as some of them lack the health insurance covers. In addition, team working and shared responsibilities might cause medical errors thus threatening the safety and well-being of the patient through the wrong administration of treatments. A study by Mary et al., (2004) confirms the presence of healthcare discontinuity, medical errors, adverse outcomes and lack of coordination in hospitals associated with medical handovers. This occasionally poses healthcare safety risks affecting the recovery of the patient(Rogers, 2004). With the aim of providing continuous and quality care to patients, the St Catherines Community Hospital healthcare staff should ensure timely services to the patient and this involves the intervention of various healthcare practitioners and the hospital’s communication system. Purpose In spite of having a well-coordinated system in St. Catherines hospital, safety issues are bound to arise especially during treatment causing medical errors which would eventually impact the health of the elderly people whose immunity is already compromised by increased factors. This is possible because; the management cares of the hospital emphasize coordination and the hospital is built upon the culture of shared responsibility. These two factors are essential in the facility because they enhance fast and effective delivery of care to the aged patients. However, sharing responsibilities could occasionally result in errors particularly in the event of lack of coordination and effective communication among the healthcare practitioners. For instance, a doctor might administer a certain drug or form of treatment to a patient and forget to notify their colleagues. These results in a fatal scenario as another staff member end up administering the same drug to the patient without their knowledge thus, threatening their safety. Furthermore, the scenario increases the treatment costs of the patient. This proposal has therefore identified a gap in the communication and delivery of information in the hospital. This gap impacts the safety of the elderly patients in the hospital through the increase of medical errors resulting from shared responsibilities and coordination issues among the healthcare teams. Secondly, the gap poses financial constraints not only to the patient but also to the hospital at large because; increased costs are incurred in treating a wrongly diagnosed patient. Proposal Initiative This proposal develops an effective information system to facilitate coordination within the hospital and among the healthcare practitioners in St. Catherines Community Hospital to prevent the occurrence of safety and financial issues impacting both the patients and the organization. It will involve the development of software by the information technology department that will allow the entry of patients numbers, the services required at the particular time and the status of administration of the treatment. As a result, every patient will be identified by the system every time a doctor is attending to them and the treatment entry will be filled when the current services have been delivered to them with the name and the number of the health provider. This will facilitate the differentiation of the attended patients from those who are yet to be attended. This application will be installed in every physicians mobile phone to affect the operation. In this case, every doctor will also be notified of their required attention to a particular patient in case of an emergency through the system thus ensuring that every activity in the medical care facility is carried on efficiently. Also, coordination will be improved and medical errors causing safety issues in the organization will be prevented. Therefore, the proposal intends to develop a notification system through the communication department of the hospital to ensure that the practitioners are frequently notified of their allocated patients and their healthcare issues to facilitate coordination, reduce errors and guarantee the patient safety Leadership Healthcare leadership plays significant roles in the administration and running of an organization. In essence, hospitals face challenges in healthcare funding, the ability to access many consumers as well as the capability to sustain a wide coverage of people. More so, they encounter operational and safety problems which affect the running of their organizations. This demands strategic leadership which is supported by good communication and decision making, equity, transparency, integrity, passion for serving, motivation and inspiration (Naylor et al, 2004). This will facilitate the development and adaptation of policies, projects, and proposals intended to bring positive changes to the organization. The leadership of St. Catherines hospital plays the administrative roles which involve the development of policies and new projects and ideas intended to bring development to the organization. In this case, the engagement of leaders will help formulate ways of improving safety since the project depends on their approval. Apparently, they have not yet identified the problem and therefore the proposal will be of great importance in the identification of the safety issues within the organization. As such, I believe that the leaders of the organization will consider the implementation of my proposal since the project intends to improve health care delivery to the elderly through the enhancement of safety as well as reduce the operational costs of the hospital thus increasing profits and facilitating development of facilities and structures that support the safety and well-being of the aged in the society. References Aase, K., Laugaland K. A, Dyrstad D. N, Storm M. (2013). Quality and safety in the transitional care of the elderly: the study protocol of a case study research design (phase 1). Retrieved on June 25, 2018 from Mary D.,Dorothy A., Roberta L., Greg Maislin M, Kathleen M., Sanford, S. (2004) Transitional Care of Older Adults Hospitalized with Heart Failure: A Randomized, Controlled Trial. Retrieved on June 25, 2018 from Naylor, M. D., Brooten, D. A., Campbell, R. L., Maislin, G., McCauley, K. M., & Schwartz, J. S. (2004). Transitional care of older adults hospitalized with heart failure: a randomized, controlled trial. Journal of the American Geriatrics Society, 52(5), 675-684. Rogers, A. E., Hwang, W. T., Scott, L. D., Aiken, L. H., &Dinges, D. F. (2004). The working hours of hospital staff nurses and patient safety. Health affairs, 23(4), 202-212.
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