Category: Action Plan

Theory and usefulness

The skill area under consideration is listening. Theory on the subject reveals that listening may occur at various levels, starting from the least effective to the most effective. At the bottom of the pyramid is passive listening, which is a synonym for not listening. Usually, this level of listening occurs when the person feels that what the speaker has to say is unimportant.

It takes no effort at all and may be detrimental to organisations with high levels of it. The next level is responsive listening, which is also called pretend listening. In such scenarios, persons will not care about what the speaker has to say but will pretend to listen in order to appease them.

Usually, this process will involve nodding and the use of typical listening cues like ‘aha’ or ‘yes’. Eventually, such persons will not recall what was said. This type of listening is deceitful because it attempts to disguise a listener’s lack of interest in the conversation.

Projective listening is the third worst form of listening; some experts like to call it biased listening. It is an approach in which a person already has a strong opinion about the topic under discussion and will project this opinion onto the speaker. The listener may hear what is being said but his biases may cause him to disregard the speaker’s words.

This person is usually defensive and will not allow the speaker’s assertions to change his opinion about something. In close association with this type of listening is misunderstood listening. Sometimes a person may listen and even be open to suggestion. However, the listener’s interpretations could cause him or her to alter those words in order to fit into their version of the issue.

Such individuals would not know that they are actually engaging in selective hearing as their mistake is not intentional. Nonetheless, it is still as dangerous as the other forms because a person would not truly understand a speaker’s feelings. Organisations with such kinds of managers will be confronted with unexpected departures or conflict since employees will feel misunderstood (Bentley, 2000).

The next level is attentive listening for data alone. In this form of listening, a person concentrates only on the words that someone says and does not bother about the other aspects of communication like non verbal cues or intonation. Therefore, the person will hear what another person has to say but will fail to contextualise it. Such an approach to listening places greater emphasis on facts rather than the motives behind the message.

Effective communication depends on a listener’s ability to understand the feelings and emotions that surround what a speaker is saying. This implies that the communication is still superficial. Managers often require their sales persons to be aggressive or persuasive when pursuing new clients.

Usually, these sales people will exhibit some form of attentive data listening. They might manipulate clients into committing to something, but will not care about the non verbal cues of the customers. As a result, their approach hampers those clients from bringing business back to the firm.

Active listening is an improvement on attentive data listening as it involves understanding the verbal and non verbal forms of communication. At this level, listeners take in the emotions and feelings associated with what is being said. On the other hand, this is still not a superior form of communication because it does not involve empathising with the speaker.

Such managers would understand facts and place matters into context but few of them would use those feelings to react to the speaker. Several individuals adopt this form of communication because they feel constrained by company policy.

Alternatively, others may choose to listen actively because their level of emotional maturity prevents them from engaging deeply. Some people may be too insecure to engage further or others might simply have their own agenda. They may intend on manipulating others thus lacking the ability to identify with the speaker.

A more mature way of listening is empathetic listening. Here, a person pays attention to the voice, the actual words, the cultural background, feelings as well as the non verbal cues of communication.

Sometimes this may involve the pace at which ones speak as well as their facial expression, their volume as well as their style and general feelings. This component also involves reacting and offering feedback to the speaker. Sometimes one may take actual notes of the conversation or mental ones.

Additionally, it may also entail showing understanding in a manner that will minimise the build up of emotions. Managers who engage in such types of listening are quite sincere and successful in their duties (Cohn, 2007).

The top-most level of communication is known as facilitative listening. In this form of communication, the listener will go beyond merely understanding or analysing the emotions and non verbal cues of the speaker. Instead, the person looks out for genuine signs and outputs. It is sometimes possible for speakers to say one thing and do another.

Therefore, facilitative listeners are the most effective because they get to the root of a communication. Studies indicate that some people may be hiding their emotions subconsciously. Therefore, the facilitative listener assists the speaker to reach out into himself and understand the potential he has to solve those problems. He expounds the choices and lets the speaker know that he has his support.

Facilitative listening may not be appropriate for all situations since emergency situations could impede it. Legal issues as well as organisational policy may come in the way of such a method. Managers who exhibit this form of listening are highly valuable. Nonetheless, some of them may be constrained by company policy.

It is a selfless form of listening as it is not motivated by personal gain. Instead, such a listener only wants to assist the speaker to achieve his interests.

Implications of listening in management practice

Management practice is incomplete without proper listening skills. This spans throughout the entire job description. For instance, managers often have to hire new employees when gaps arise or new functions come up. An organisation needs to decipher the truth behind a person’s CV or job application letter.

It is not always possible to write everything about oneself in these documents, so effective listening skills enable administrators to understand a little more detail about the candidate’s competencies. Furthermore, a manager who listens well can also deduce the kind of attitude that the applicant will bring into the organisation. This skill area will thus ensure that managers hire persons who are a right fit for their organisations.

The success or failure of projects depends on managers’ ability to listen. If a person’s department is in charge of a new project, some anomalies may develop along the way. Managers have the capacity to tackle small problems as soon as they arise and thus prevent them from turning into crises. However, this mitigation can only come about when the manager listens to his team members effectively.

Sometimes it may come in the form of a concern. Alternatively, some workers may feel that their strengths are incompatible with the work to which they have been assigned. They may try to convey these insecurities indirectly, and it is only the effective listener who will understand those cues.

Managers who do not focus on these statements may assign workers to project areas that are incompatible with their strengths and this could harm project outcomes.

Effective listening is crucial in management because it gives one ideas on how to enhance performance (Janusik, 2005). For instance, an employee might talk about the need to alter seat arrangements such that they might concentrate on their work. Alternatively, a worker may request for masks from his supervisor to protect him from mould. The effective listener will note these concerns and thus do something about them.

Eventually, the workplace will have fewer workplace injuries and thus greater productivity. In companies where managers listen to employees, people are more likely to give alternative solutions to problems. Therefore, managers are not left with all the work. Additionally, these individuals tend to me more creative as they know that their input will be heard. This adds value to the company and makes it more conducive for growth.

Interactions between management and external stakeholders make the difference between leading firms and insignificant ones. Maintaining strong customer relationships is dependent on how well one listens to one’s clients. Most times, customers with something to complain about will usually request for the manager.

If the manager listens to the client effectively, then the problem will be dissolved and the company will have maintained its reputation. The same applies to customer care efforts. If management does not emphasize the importance of effective listening, then customer-care employees will not listen to consumers and this could lead to dissatisfaction or abandonment of business with the company.

Similar principles apply to interactions between an organisation and its suppliers or other business partners. Managers must maintain satisfactory relationships with their partners or this could cause them to look elsewhere. The only way a business will develop a relationship with its external partners is through listening to them.

Maintaining a positive and conflict-free culture is crucial in heightening production. Managers can build such cultures by listening to others and teaching their subordinates to do the same. This approach prevents misunderstandings and frustrations that stem from being misconstrued. Companies where superiors dominate meetings or rarely allow members to give their input are likely to build resentment in their workers.

Many of them will start discussing these issues amongst each other and may even back bite their superiors. Such individuals tend to focus more on gossip and rumours rather than work.

Likewise, a manager may boost morale by listening to the things that motivate their workers. Not all employees can respond to the same incentives or rewards. Therefore, managers ought to pay attention to these aspects in order to customise reward plans to each employee. This would definitely increase outcomes and make for a better work environment.

Action plan

The action plan involved a six – step process. First, I identified the listening approach that I use and why I need to improve it. I realised that I used to engage in attentive data only listening. This came from the fact that I never knew how to read people’s non verbal cues.

Whenever someone spoke about body language, I always failed to understand what they were saying. Additionally, I have always been a practical, hands-on person. Social interactions are not my forte, so reading people’s unsaid messages was definitely a challenge.

The next step in the action plan was understanding nonverbal communication by observing someone who was really good at it. During that week, I found that the person was rarely distracted when talking to others. In other words, she rarely focused on her phone, email or other distractions when conversing. I also found that she was available to her colleagues every time they called on her.

It seemed that she had a positive attitude towards these persons all the time. My colleague was keen on making eye contact but she also observed what was around her. When I asked her how she read non verbal cues, she maintained that posture was the first thing she considered. If a person slouched and rested his head on his arm, then she would deduce that the person was disinterested.

Additionally, facial expressions were an immediate give away. She said that sometimes people smiled yet their eyes sent a totally different message. Therefore, she preferred to rely on the latter than the former.

My communication role model also seemed to react to the dynamics of voice as she would increase or decrease it in response to the speaker. She usually gave feedback to others and even repeated some of the things the person was saying.

After knowing what active listening entailed, I started working on identifying the barriers that keep me from listening accurately and thoroughly. First I noticed that I always have a lot on my mind when speaking to people (Moulic, 2012). Sometimes this causes me to get distracted as I will plan my day or think about where I will buy supper.

This tendency to clatter my mind with several things is what keeps me from reading non verbal cues. I have also realised that I did not understand some of the cultural cues for non verbal communication. I was simply not aware of these components, so it was difficult for me to identify and respond to them in kind. I have always been a matter-of-fact person who focuses on the bottom line in any of life’s endeavours.

Therefore, it is easy for me to look for the main point in everything and dismiss the rest. Another obstacle that prevents me from listening actively to others is the frequency of communication. I hate the silence that comes between certain phrases and will say anything to fill that gap.

I needed to get comfortable with momentary periods of silence during conversations. Sometimes when people speak, I may start thinking about what to say in return, and this prevents me from engaging with the speaker. Anxiety causes me to dwell on the things that will come next rather than what they are actually saying.

Another reason that causes me to be an ineffective listener is that I have never encouraged other people to keep speaking. Most times, lack of eye contact or poor response to people’s expressions can cause me to misunderstand them. Perhaps the biggest obstacle is the lack of intent to listen. Once I change this attitude, then everything else will fall in place.

I also used memory aids in order to identify the instances that led me to ineffective listening. First, I bought a diary in which I would write about my communication experiences for the day. I would recall instances in which I had not understand non verbal cues and would describe them at length.

Sometimes these scenarios would be concentrated in one session but in other instances they would be distributed in different scenes throughout the day. I used my mobile phone as a recording device. It was quite insightful to listen to my own voice from an objective point of view. I found that it was easy to detect tension-filled moments or situations when I was contemplating what to say.

The next phase of my action plan was going through listening exercises. One of the exercises I found useful was listening to all the information I could absorb before making a contribution. I practiced delaying my responses until all the information in the conversation had been collected (Emanuel et. al., 2008).

I also found that if I focused on what was new rather than what I already knew, then I was more likely to listen to the person. The tendency to respond to what I had heard before often caused me to be too engaged with my own issues rather than to listen to the speaker. Therefore, I practised focusing on the things that I did not know rather than what I knew.

The last component of the action plan involved practising habits of active listening. For this part, I approached my role model and had an imaginary conversation. In one instance, we talked about the food at a common restaurant.

She stated the following: “Am so frustrated by the soup at Ramitas; it always seems bland or too spicy. They just can’t seem to get it right.” I replied by saying “Oh, is that so? I had no idea.” My role model congratulated me on that reply because it came at the right time. She also noticed that I was maintaining good eye contact and did not confront her.

I am still working on the last part of the action plan as I will forward my findings to the tutor in order to get acknowledgement. I am also working on my personal approach to listening as I would like to move from active listening to the most advanced method of listening, which is facilitative listening.

Outcomes

The outcomes of improved listening will be better results in school as well as in other gatherings. If I listen better in class, I will recall more and thus increase my chances of passing exams. Additionally, it is likely that I will strengthen the relationships I have with my friends.

When I remember what my friends say, many of them will be impressed by this and will feel connected. Active listening can also cause me to make new friends easily as I will recall important details about their lives.

Currently, learning to listen to non verbal cues will allow me to detect instances in which gestures do not match behaviour. This will allow me to seek clarification on what the speaker really means. In essence, I will deal with hidden issues that make people unhappy.

In the future, when I become a manager, it is likely that I will be an effective supervisor. My subordinates would trust me with their ideas because they would know that I will listen to them. The employees may become more comfortable with the workplace as they will have a senior who listens to them.

Measures of achievement

In order to determine whether I have succeeded in being an active listener, I will use a pen and paper to analyse conversations. I will write down the things that the person was saying. If I cannot remember any of these words, then it proves that I was not listening actively.

I will also get back to speakers on a weekly basis and try to interpret what they meant to say during conversations we had with them using their non verbal cues. If the speaker agrees that my interpretation of their feelings was accurate, then I will have succeeded. In other words, I will match their mood with their non verbal forms of communication (King et. al., 2006).

I will also engage in practice sessions with friends. In this regard I will ask them certain questions like how they spent their weekend. I will then expect them to ask me questions about what they said and whether they actually meant it. If I give them correct answers, then I will have become a good active listener.

References

Bentley, S. (2000). Listening in the 21st century. International Journal of Listening, 14 (3), 129–142.

Cohn, K. (2007). Developing effective communication skills. Journal of Oncology practice, 3(6), 314-317.

Emanuel, R., Adams, J., Baker, K., Daufin, E. K., Ellington, C. and Fitts, E. (2008). How college students spend their time communicating. International Journal of Listening, 22(2), 13–28.

Janusik, L. (2005). Conversational listening span: A proposed measure of conversational listening. International Journal of Listening, 19(4), 12–28.

King, G., Servais, M., Bolack, L., Shepherd, T. & Willoughby, C. (2012). Development of a measure to assess effective listening and interactive communication skills in the delivery of children’s rehabilitation services. Disability Rehabilitation Journal, 34(6), 459-469

Moulic, M. (2012). Developing effective listening skills to enhance professional efficiency. International Peer Reviewed Journal, 3(22), 64-87.

Healthcare facilities in the United States are keen on getting Joint Commission accreditation because of various reasons. According to Bowie and Green (2016), and accreditation by this commission is considered the gold standard in the field of healthcare. The accreditation focuses on continuous quality improvement of services that a healthcare institution offers and the safety of patients and the medical staff (Lambert, 2016).

Getting accreditation is a sign of quality services that a healthcare facility offers. Most of the state governments in the country recognize the institution’s accreditation when defining conditions for receipt of Medicare and Medicaid reimbursements (Burns, Bradley, Weiner, Shortell, & Kaluzny, 2012). As the executive director of ABC Healthcare Center, the researcher has to find ways of pursuing the Joint Commission accreditation.

It will help this institution to convince its clients that its services meet the criteria set by the government and other relevant institutions. The achievement will also enable this institution to get financial benefits from the government in the form of Medicaid reimbursements. In this essay, the focus is to review what it takes for this institution to achieve the accreditation and challenges that the team should expect.

The Management of Challenges of Delivering Value in Healthcare

When striving to deliver value in the healthcare sector, especially when the focus is to get the Joint Commission accreditation, a firm should be ready to overcome various challenges. One of the biggest challenges, according to Bowie and Green (2016), is bureaucracy. Many institutions in the United States are keen on embracing the open-door policy where employees can easily engage their superiors when they feel such an action is necessary.

However, Goldsmith (2014) claims that most of the systems embraced in this country are bureaucratic, making it difficult for top managers to engage junior employees as frequently as would be desirable. As the director of this organization, one of the steps that will be taken would be to eliminate all bureaucratic systems and structures within ABC Healthcare Center as a way of improving communication.

Human relation is another major issue that affects the quality of service that a healthcare facility delivers. Nurses, doctors, and other medical staff should have a good working relationship where there is mutual respect. Such a kind of environment is often created by the management approaches that an institution embraces. The director and other senior managers should not be seen to favor a section of employees, such as doctors, at the expense of other staff members. Such preferences often create a rift among workers. The process of making critical decisions that affect the workforce should be as inclusive as possible. The management should avoid making arbitrary decisions that may be rejected by the medical staff because such actions may affect the quality of services that the facility offers.

The institution should not ignore socio-economic disadvantages in its quest to achieve the accreditation. It is common to have cases where some of the patients who come to the facility lack healthcare insurance cover and the financial ability to pay for services they need. Burns et al. (2012) argue that an institution that constantly rejects patients on the basis that they cannot pay for the services may receive criticism in society, limiting its ability to get Joint Commission accreditation. As such, it would be prudent to have a contingency plan that can enable the hospital to fund services offered to patients who cannot pay.

Leadership and Management: A Framework for Action

ABC Healthcare Center can only get the Joint Commission accreditation if it embraces specific leadership and management principles. According to Bowie and Green (2016), management entails defining responsibilities, assigning roles, and supervising how workers undertake their duties while leadership entails guiding and motivating employees towards a given vision. Administrative leadership brings together the principles of leadership and management.

Goldsmith (2014) defines administrative leadership as orchestrating tasks, which involves hiring, assigning responsibilities, and managing output, and motivating the workforce to develop and sustain development. This approach of leadership will be critical in ensuring that various medical staff understand their responsibilities and remain committed to the delivery of quality services.

Transformational leadership is another concept that the director will embrace in this institution as a way of improving the quality of service delivery. This theory of leadership emphasizes the need for the manager to encourage, motivate, and inspire workers to be creative and innovative as ways of creating change and enhancing organizational success (Burns et al., 2012). It also encourages the management to embrace the concept of followership. One can only be a good leader if they understand the concept of leadership. It means that a manager should be willing to cooperate with junior employees, understand their needs, and design ways of meeting them. Developing SMART (specific, measurable, attainable, relevant, and timely) objectives when undertaking every project would also help this facility to get the accreditation. The team will know what needs to be achieved within a specific period using specific resources.

Organizational Design and Coordination

In an organizational setting, one of the most important factors that define the ability to realize the set goals is the management design and coordination strategies embraced. Every stakeholder should understand their role within the system and how they need to coordinate with others. The chain of command should be defined to avoid cases of insubordination and overlapping of tasks. Figure 1 below shows the proposed organizational structure that should be embraced at ABC Healthcare Center.

At the helm is the executive director who will be responsible for managing daily operations at the firm. The director will work closely with the chief fiscal officer who will offer advice on the financial capacity of the institutions and areas that should be given priority based on the financial position of the firm. The facility will have four vice presidents who are reporting directly to the chief executive officer. They include the human resource director, patient care services director, support services director, and medical affairs director.

These directors must ensure that their activities are closely coordinated to enhance the ability of the institution to achieve its vision.

Motivating People

Hiring and retaining a group of talented employees is just one of the steps needed to ensure that a firm achieves its vision. Motivation is another important aspect that encourages employees to deliver the best output in the workplace environment. Bowie and Green (2016) explain that many institutions often use monetary strategies to ensure that workers are motivated. However, Burns et al. (2012) believe that motivating employees goes beyond giving them financial benefits.

Employees get inspired when they work in an environment where they feel respected, cherished, and allowed to participate in decision-making processes within the firm. The human resource director and supervisors within the department have the responsibility of understanding personal and work-related issues that affect employees. When such issues are identified, the department should device proper ways of addressing them to improve the output of workers. The framework shown in figure 2 below can help in diagnosing issues within a firm and finding ways of addressing them.

As shown above, the first step is to identify need deficiency. The management should understand fears, concerns, and issues that may trouble the medical and non-medical staff within the institution. The next step is to search for ways of meeting the identified needs. The team can develop alternative ways of addressing each issue and then evaluate each of them to select the most appropriate alternative.

When the need has been addressed, a plan should be developed to address a similar need should it arise in the future. Goldsmith (2014) argues that Maslow’s hierarchy of needs may also help in motivating employees in the workplace. When using this model, one needs to define the position of the employee within the hierarchy of needs. The classification helps the management to determine the most appropriate way of meeting these needs.

Figure 3 below shows the model. Most of the medical staff have psychological needs, which include esteem needs and a sense of belongingness and love. When defining ways of motivating these employees, their position in the pyramid below should define the path that needs to be taken. The assumption made is that their current jobs make it easy for them to achieve basic needs.

Teams and Team Effectiveness in Healthcare Services Organization

The management of ABC Healthcare Center should define teams responsible for undertaking various tasks that would help the institution to get the Joint Commission accreditation. In this strategy, the director will go beyond a given department to the unit level where different teams of medical staff work closely to offer services to customers. Given that service delivery in a healthcare setting involves close coordination of different experts, the management must remind doctors, nurses, and clinical officers that they form a team and that their success depends on their ability to coordinate their activities.

Types of Teams in a Healthcare Setting

One such team is the intensive care unit. The unit is crucial as it handles patients in critical condition. When defining SMART goals for this unit, the focus should be on the number of patients who come out of the ICU alive despite their delicate condition. The surgical unit team is responsible for operating on patients with varying conditions. Burns et al. (2012) state that this unit is also very sensitive and its success is often determined by the number of successful operations per given number.

Surgeons, anesthesiologists, nurses, and medical specialists such as cardiologists often form a team in the surgical unit. Within this team, the responsibility of every expert remains clear to avoid any confusion. Some surgical processes are so sensitive and demanding that team members must work in a coordinated manner. Any mistake or unnecessary delay may cost the life of a patient. Other important teams include emergency response unit, medical wards units, delivery units, primary care units, and multidisciplinary teams,

Appropriate Model of Improving Teams’ Effectiveness

The appropriateness of each of the teams identified is based on their size, diversity, and composition. For instance, an ICU unit should have the right number of nurses, medical doctors, and other experts needed to make the process a success. The size of the team may vary depending on the complexity of the assignment and the type of medical experts needed. The composition of the team should be right.

In an ICU, the surgeon, the anesthesiologist, nurses, and cardiologists have very specific responsibilities. It is not possible to complete the process when one of the needed experts is not available. The team cannot replace the cardiologist with a general physician because the skill and experience needed are specific. Diversity may sometimes help the team. A woman would feel comfortable when nurses handling her are female officers. A diversified team makes it easy for the patient to feel comfortable and protected if he or she can identify with some of the medical staff.

Communication

Communication is one of the most important factors that define the ability of an institution to achieve its vision. ABC Healthcare Center is not only focused on improving its service delivery but also getting the Joint Commission accreditation. It means that its services must meet certain standards set by the commission. When the commission sends its experts for a site review, they should not only find an environment where set specifications are met but also a team of employees who can communicate effectively when asked specific questions. As shown in figure 4 below, the entire process of communication starts with the sender who encodes a message through a given channel.

The recipient then decodes the message to get the intended meaning before giving feedback (Burns et al., 2012). Communication can break down because of wrong encoding, barriers associated with the channel used, or mistakes during the decoding stage. Such challenges should be addressed to ensure that different teams could coordinate their activities and communicate with the top management unit to address concerns that may exist.

Doctors, nurses, and clinical officers should have effective ways of communication within this institution. When a doctor evaluates a patient and believes a nurse should administer a given medicine, the information should be communicated in simple and clear terms. When the condition of the patient is not yet clear and further laboratory tests are needed, the message should be sent to the relevant clinical officers.

Using an integrated internal digital communication platform may help in posting the progress made on a patient and stages that remain in administering the right medication. The digital platform is effective when handing over a patient at the end of a doctor or a nurse’s shift. The new team will understand what has been done and what should be done on the patient. During the site visit, officers from the Joint Commission should find an effective digital communication platform that makes it easy for the staff to pass and receive relevant information about their patients.

Power, Politics, and Conflict Management

Power and politics within ABC Healthcare Center may have a significant impact on its ability to get accreditation from the Joint Commission. Unions of employees such as The Union of American Physicians and Dentists (UAPD) or National Nurses United have the power to define activities of their members in various healthcare institutions in the country (Sui & Rui, 2016). They can call for a strike among their members or go-slows when they feel their needs are not met.

This healthcare facility may not restrict its members from joining the unions. However, the management can create a conducive work environment that makes nurses, doctors, and clinical officers that they do not need to join these institutions to fight for their rights. Their salaries should be within or above the market average and occupational health and safety rules observed in the best way possible. Goldsmith (2014) advises that it is important for management to avoid power politics in the workplace.

Conflicts would arise frequently among different stakeholders in the workplace. Finding effective ways of resolving conflicts would improve the quality of services delivered to patients. Burns et al. (2012) believe that dialogue is one of the best ways of managing conflicts. Whenever there is an issue affecting a team of employees or an individual staff member against the other, the management should encourage the affected parties to embrace dialogue. It may also be necessary to have mediation teams within the firm to address concerns that cannot be managed through dialogue.

Conclusion

ABC Healthcare Center needs Joint Commission Accreditation to ensure that it can get various financial benefits from the government. The accreditation is also an assurance to clients that this institution offers high-quality services. In this plan, the researcher has identified various steps that the management must take to achieve the intended goals. The plan has also identified challenges that the team should expect as they strive to achieve the intended goal. If the management implements this plan, the institution would be able to get the accreditation.

References

Bowie, M. J., & Green, M. A. (2016). Essentials of health information management: Principles and practices. Clinton Park, NY: Delmar Cengage Learning.

Burns, L. R., Bradley, E. H., Weiner, B. J., Shortell, S. M., & Kaluzny, A. D. (2012). Shortell and Kaluzny’s healthcare management (6th ed.). Clifton Park, N.Y: Delmar.

Goldsmith, S. B. (2014). Understanding health care management: A case study approach. Burlington, MA: Jones & Bartlett Learning.

Lambert, P. D. (Ed.). (2016). Managing arts programs in healthcare. New York, NY: Routledge.

Perley, R. (Ed.). (2016). Managing the long-term care facility: Practical approaches to providing quality care. San Francisco, CA: Jossey-Bass.

Sui, P. L., & Rui, Z. (2016). Service quality for facilities management in hospitals. Singapore, Singapore: Springer Singapore.

Introduction

Many regard physical activities as a prized way to spend one’s spare time and an essential part of life. However, while many people enjoy the liberty to have a sport’s center subscription and participate in its events, individuals with physical disabilities find it challenging to incorporate it into their everyday lives. Despite the governmental regulations obliging businesses to have equal opportunities for everyone, many fitness venues simply lack the accessibility measures to allow people with impairments to enjoy their services. Although enabling people with disabilities to easily enter and employ the establishment is a fundamental human right, leisure centers all over the world still miss out on the extensive client group of customers with disabilities. More specifically, wheelchair users are often widely misrepresented when it comes to access to sports despite their great need for physical treatment. This paper will present an audit of the wheelchair users’ accessibility to the Whitlam Leisure Centre facilities, specifically the pool area, as well as offer a one-page recommendation for better accessibility practices.

Organization Audit

Service Being Assessed: ­­­­­­­­­­­­­­­­­­­­­­Pools Facilities

Location: Whitlam Leisure Centre

Transport Access: By car parking

Date of Assessment: May 14^th, 2020

Overview of the Service and Location

The facility under review is the Whitlam Leisure Centre in Liverpool, Australia. It provides services of five heated pools, both indoor and outdoor, with varying depths and capacities. The Centre also enables its customers to attend regular fitness sessions, sports competitions, and the ability to rent various parts of the establishment for events. The administration claims to deliver quality health and leisure events regardless of the customers’ goals, age, preferences, and abilities. It is advertised as an accessible institution with parking and access for disabled people.

Funding

According to the annual report of the spending and action plan for the next five years for the sports establishments in the region, there are various funding sources for Whitlam. The major financial resource is the Liverpool City Council, as well as the revenue of the Centre itself (Liverpool City Council, 2019). In addition, two other charity foundations help to support the accessibility of the institution: the Ian Potter Foundation and NDIS.

Disability Services

According to the official website of the Whitlam Leisure Centre, the facility ensures enough parking spots for people with disabilities. Another aspect of usability is wheelchair-accessible entrance and access to the pools. Although these points are significant, they are the only ones that are mentioned. As per accessibility for people with hearing or a visual impairment, there is no available information. In 2015, the Leisure Centre hosted a charity event to support people with disabilities and encouraged them to attend the establishment’s activities by raising funds (Liverpool City Council, 2019). On the other hand, wheelchair users neither have participated nor were mentioned during the campaign. Since then, no specific disability-oriented groups and activities have been introduced.

Customers with Spinal Cord Injury Overview and Justification of Choice

The type of condition chosen for this particular audit is acute spinal cord injury (SCI), specifically with no or moderate walking capability. “Typical impairments associated with SCI include spasticity, contractures, weakness, and pain resulting in loss of functional abilities” (Recio et al., 2017, p. 109). Given that people with such impairment are regular wheelchair users that heavily rely on physical activities for treatment and leisure, making sports faculties accessible to them is a valuable addition to discrimination-free establishments (Calder et al., 2018). However, there are still multiple barriers between a person with SCI and successful sports participation. Despite numerous benefits that disabled people gain from sports therapy, many wheeled mobility device users still face difficulties when trying to access water pools (Koontz et al., 2020). Furthermore, the businesses’ legal obligation to sustain equal opportunities for their clients regardless of their impairments is not fulfilled. Given these points into consideration, this specific physical impairment has been chosen as a user perspective to review the Whitlam Leisure Centre.

Physical, Emotional, Cognitive Requirements for Wheelchair Users’ Accessibility and Participation

Considering the specific needs of wheelchair users with SCI is extremely important in addressing them and achieving equal accessibility. As people who have limited mobility and require a transportation device like a wheelchair, physical requirements are one of the most important ones to take into account in the build surroundings. Additionally, wheelchair users require environmental variables like “multiple fixed setups (e.g. more than one accessible bathroom stall), adjustable accessibility features, availability, public access to transfer assist devices, and lack of slippery surfaces” (Crytzer et al., 2016, p. 4). Other spinal cord injury sufferers’ needs that regularly arise are “minimizing or bridging the gap and height differential between the mobility device and transfer surface, providing foot support, and adding grab bars” (Crytzer et al., 2016, p. 4). Aspects like space adjustments for the transfer surface to enable free maneuvering of the wheelchair, as well as the available location to store the device are essential physical demands.

As it concerns the emotional aspect of the accessibility, social factor requires close attention. People with spinal cord injury frequently report “feeling unsupported by the attitudes of health professionals, fitness center staff and, at times, family members and friends” (Calder et al., 2018, p. 526). Therefore, lack of informational materials, disclosure of accessibility, and understanding from staff can be an obstacle to community participation that needs to be eliminated to fulfill the emotional needs of people with spinal cord injury.

Whitlam Leisure Centre Accessibility Overview

Accessibility to the Building

The first significant aspect that needs to be taken into consideration when auditing the building from the wheelchair-user perspective is the accessibility of the venue, both internally and externally. Although, as the Centre’s administration claims, disabled parking is abundant, its location is not convenient and poorly laid out. The way the accessible parking spots are positioned puts people with physical impairments, specifically wheelchair users, in a position where they have to employ unnecessary wayfinding to reach the entrance of the location (Koontz et al., 2020). Furthermore, internal navigation might be difficult for people with disabilities since the old building has been repurposed numerous times and has been improperly integrated (Liverpool City Council, 2019). Thus, wheelchair users might find themselves wondering about the internal spaces and halls with no apparent way out.

Access to Services

The Whitlam Leisure Center provides inadequate access to the services from the perspective of the wheelchair user. Although entering the building itself is manageable, accessing the registration desk with no assistance is complicated due to the lack of space for maneuvering (Crytzer et al., 2016). However, all the pools have the required disability ramp to enter the water. Changing rooms and toilets are accessible, yet do not provide any specific assistance for wheelchair users. As per the seating area around the pool, despite the necessary slippery-free surface, there is no assigned space for mobility devices and their caregivers.

Access to the Website

The website of the Whitlam Leisure Centre does not provide adequate accessibility support for people with disabilities. The contrast of the text over the background is not sufficient for the customer with low or blurred vision. Since spinal injury can cause moderate to severe damage to nerves and lead to visual impairments, the high contrast and ability for extreme zoom-in are the necessary aspects of making the website accessible (Rimmer et al., 2017). While the site is still able to display information accurately when magnified, it does not showcase enough color contrast for the client to see appropriately. Furthermore, the pictures lack the alterative description that can be used instead of the photos to understand the context.

Usability of Physical Resources Reducing Barriers

First of all, although there are wheelchair ramps to enable access to the main building, the pools themselves, and the adjacent café area, many of these adjustments are placed in an unsuitable location for proper use. For instance, one of the outdoor pools displays the inappropriate location of the ramp that makes it inaccessible (Liverpool City Council, 2019). As per accessing the aquatic features of the Whitlam Leisure Centre, the facility lacks the updated set of measures to ensure the inclusion of people with spinal cord impairment. The water features also require the disability hoist or pods that allow wheelchair users with the ability to transport themselves and enter the water. One of the heated pools is also too small for meeting the condition’s guidelines to conduct sport group sessions and lessons due to the lack of space (Liverpool City Council, 2019). Additionally, toilets and changing rooms do not allow pertinent access for wheelchair users due to the lack of width doors and absence of hand ramps and slippery-free spaces (Calder et al., 2018). Changing rooms miss tables and do not allow customers to dress independently.

Recommendations for Reducing Barriers

According to the audit performed above, there are numerous recommendations for reducing barriers to wheelchair users’ participation. First, a convenient parking space should be relocated closer to the entrance to minimize the wayfinding time and difficulty. Second, applicable toilet and changing table features need to be included to assist mobility device users with their physical needs (Crytzer et al., 2016). The disability ramps and ceiling elevators need to be relocated for easy pool access. Accessibility technology like pool pods and pools with particular measurements for SCI people can be introduced for better community participation.

Best Practice for SCI Wheelchair Users to Undertake Aquatic Therapy

Overview of condition

The condition chosen for this guideline is moderate spinal cord injury that is associated with decreased or absent mobility of the person and a great need for exercise. People with SCI of severe and moderate-intensity need a wheelchair to assist them in their limited mobility for transportation. Thus, their lives are restrained by a lack of physical exercise.

Activity to Undertake and Precautions

The specific activity that people with spinal cord impairment will need to undertake is aquatic therapy, which is a set of exercises done when remaining underwater. According to Rimmer et al. (2017), some people with SCI can significantly benefit from various exercises. The benefits are highlighted if done underwater since the pressure and the decreased weight can ease the tension in reduced mobility’s muscles and stimulate pain-free activity. “In addition to functional improvements, patients receiving aquatic therapy demonstrate changes to ventilatory function” (Recio et al., 2017, p. 216). Although the activity has been proven to have positive effects on people’s mobility and pain coping, no exact safety measures have been put in place on the governmental level. Consequently, the venue needs to implement all the safety measures possible to ensure security.

Expected Outcomes

The disability population participation is expected to have a positive effect on the physical and emotional health of the spinal cord injury sufferers, as well as on the general customer audience of Whitlam. From the disabled people’s side, this activity will assist them in reducing pain and enhancing their mobility (Recio et al., 2017). On the other hand, their active presence will lessen the stigma surrounding disability in the sports setting.

Adaptations to activity or venue for condition

Whitlam Leisure Center has to adapt its pool faculties to provide wheelchair users with the ability to attend aquatic therapy. First, the pool of appropriate sizes and heating needs to be located on the premises, surrounded by slippery-free surfaces to avoid safety threats. Second, the administration needs to place a disability ceiling heist or a pool pod to facilitate the competent entrance into the water. Third, to provide appropriate and efficient expertise to undertake aquatic group therapy sessions, qualified professionals are necessary.

Conclusion

To sum up, the audit of the Whitlam Leisure Centre has shown that the venue’s facilities are not properly adapted for the use of people with SCI or wheelchair users. While the Centre has some features to ease the customers’ mobility, many devices are misused and thus are not available. Since people with SCI disabilities are a valued part of society protected by law, ensuring their representation in sports establishments is essential.

References

1. Calder, A., Sole, G., & Mulligan, H. (2018). The accessibility of fitness centers for people with disabilities: A systematic review.Disability and Health Journal, 11(4), 525-536. Web.
2. Crytzer, T., Cooper, R., Jerome, G., & Koontz, A. (2016). Identifying research needs for wheelchair transfers in the built environment. Disability and Rehabilitation: Assistive Technology, 1-7. Web.
3. Koontz, A., Bass, S., & Kulich, H. (2020). Accessibility facilitators and barriers affecting independent wheelchair transfers in the community.Disability and Rehabilitation: Assistive Technology, 1-8. Web.
4. Liverpool City Council. (2019). Aquatic and Leisure Centres Strategy. Leisure Planners.
5. Recio, A., Stiens, S., & Kubrova, E. (2017). Aquatic-based therapy in spinal cord injury rehabilitation: Effective yet underutilized.Current Physical Medicine and Rehabilitation Reports, 5(3), 108-112. Web.
6. Rimmer, J., Padalabalanarayanan, S., Malone, L., & Mehta, T. (2017). Fitness facilities still lack accessibility for people with disabilities. Disability and Health Journal, 10(2), 214-221. Web.

The problem

Language barrier has been recognized as a major cause of racial and ethnic disparity of health provision (Woloshin, 1995). The ability of the patients to communicate effectively with the staff in a healthcare agency is of uttermost importance for several and obvious reasons. From the very beginning of the encounter between the patient and the clinician, the latter has to be able to extract accurate and detailed clinical history; otherwise, it would be very difficult to make the correct diagnosis. Consequently, there is an overrepresentation of people with poor English proficiency in the misdiagnosed cases in the United States healthcare system.

Secondly, at some point in the course of treatment, the doctor is usually required to give the patient detailed information regarding the regime or self-care; in some medical cases, failure to understand sections of this information may lead to serious and even potentially fatal consequences. While a patient may be confused by the complexity of medical information even when they have excellent English proficiency, it is unfortunate how a language barrier can compound this problem. Additionally, crucial decisions on the part of the patient may be hard to make; including issues such as giving consent for surgical procedures if the correct information is not relayed.

It has been shown that among the patients that stand experience of a potentially fatal event during hospitalization, those with poor English proficiency are overrepresented in this group (Dobson, 2007). It has been therefore recognized that the absence of trained medical interpreters in American hospitals is putting such needy patients at an elevated risk compared to their proficient contemporaries. Some of the healthcare provision agencies have tried to remedy this anomaly; however, this has not been an industry initiative; only 25% of such facilities have programs to train medical interpreters. To make matters worse, extremely few medical professionals have the right training to work with a medical interpreter (Sobralske et al, 2008).

The current conformation of the American population is telling in the manner which the health provision sector needs to provide interpretation services to their clients. About 18% of all Americans have a second language other than English; therefore, there are over 100 languages spoken in the United States (Sobralske et al, 2008). Additionally, approximately 20 million people are categorized as having limited proficiency in English; and in 2000 they accounted for about 8% of the total American population. This may seem like a big chunk of the population; however, the most alarming fact is that just a decade before this, the proportion was 6%; this is no doubt a segment that is growing at a very fast rate (Dobson, 2007); the alarm comes from the lack of preparation by the healthcare industry to handle the changing population.

The matter of the fact is that language is not the only issue that causes racial and ethnic disparity in the quality of healthcare services provided; it form a part of a larger issue of culture which also incorporates social structures, customs, values, practices and religion (Robins et al, 1998; Donini-Lenhoff and Hedrick, 2000). The factors also include sexual orientation, race, ethnicity, gender and socioeconomic status. A failure to adopt policies that favor groups that are distinctly different in the aspect of culture will lead to an alienation of this segment with serious negative implications on their general health status (Denboba et al, 1998).

The solution

The introduction of medical interpreters in healthcare setups is the only feasible solution to counter the expected growth of the segment of population that requires this service; and to reduce and prevent the disparity in the quality of services between people with a poor proficiency of English. Such interpreters would increase to safety of the patients since accurate diagnoses will be made without the barrier of language; and the patient would be able to follow the medical regimes to the latter. Additionally, the healthcare system would be made more efficient as medical professionals would spend less time on such a patient as they would in the presence of a language barrier. Therefore, the main goals of introducing interpreters in hospitals are to increase patient safety, to reduce disparity of quality of services caused by the language barriers and to improve the efficiency of the operations of hospitals.

Previously, industry regulators have tried to influence the industry to adopt policies aimed at reducing the impact of language on the quality of medical services offered. For example, in 2006, the Joint Commission of Accreditation of Healthcare Organizations sanctioned new standards that instructed all hospitals to capture the information of all patients in regards to their ethnic language so as to recognize the need to bring in an interpreter during examination and treatment (Sobralske et al, 2008). This is an improvement from the assumption that a language problem does not exist.

Action plan

The policy will be implemented in a two pronged attack; one being the hiring of trained (general) interpreters and the other increasing the number of medical interpreters trained and hired. Before, such steps are taking; surveys will be taken in the community served by the hospitals to find out the languages which are offering the most challenge to the hospitals since it’s not sustainable to hire interpreters for all languages. In real sense, people from the same ethnic origin tend to live in close communities thus there will always be the dominant language in the area. Additionally, a program to coordinate the language service between the various hospitals in a region will be created whereby they can share interpreters when the need arises.

General interpreters

This will be hired on a need basis; that is different hospitals will receive different numbers and diversity of interpreters depending on their need. Some, of the hired staff will remain part of a general pool that can be shared between hospitals and can be deployed quickly when need arise; this is especially for the less common languages where hiring permanent staff for each hospital is not sustainable. Before deployment, the staff will undergo a one month crash program to familiarize them with medical terms so that they can communicate better with the medical professionals.

The aim of this move is to cover the deficit that is already there in provision of language services in hospitals.

Medical interpreters

Teaching hospitals will be compelled to introduce medical interpretation training into their programs for those who do not have them; and to increase their intake of scholars for those who already have programs. These programs have to be approved by the Joint Commission of Accreditation of Healthcare Organizations so that they can be a standard quality. This move is aimed at preparing for the expected demand for language services in the future in lieu of changing demographics.

Challenges

During the implementation of the program various challenges barred maximum success. From the beginning, there was no proper coordination between the general interpreters and the doctors; although they had received albeit short training in medical language, they still did not know how to frame some of the questions and instructions from the doctor. This problem however is temporary since the well trained medical interpreters will have a strong foundation in medical practice. However, most medical professionals are not trained to work with interpreters; the only solution for this is to take them through professional improvement courses.

A second challenge was the unwillingness of some healthcare financing agencies to pay for interpretation services leaving the patient to foot this bill; some segments of the healthcare industry still do not consider language services as being essential for effective service provision. Consequently, some of the patients declined to utilize this service as they were not covered by the health insurance.

Finally, in some instances, crucial time was wasted waiting for the arrival of an interpreter from the general pool for some of the less common languages. There were no serious implications for the patients in questions; but the cases revealed serious shortcomings in the interpreter sharing program; this can be overcome by better planning and coordination.

Evaluation of the program

Despite the many challenges encountered, the program was a success. There was a net reduction in the number of patients experiencing potentially fatal events in hospitals among people who were categorized as poor proficient in English; this was attributed to better diagnosis and treatment of cases; and better adherence to the prescribed regime.

Additionally, the hospitals located in communities with a high concentration of bilingual people showed significant improvement in the efficiency of serving customers as the doctors were able to communicate better with their patients. The most significant benefit however was the appreciation by the medical staff of the importance of having interpreters as they were able to see their benefits themselves; this in my view was the greatest victory since future endeavors will be driven by the professionals themselves.

References

1. Denboba D. L et al. (1998): Reducing Health Disparities through Cultural Competence: Journal of Health Education 29: S47–S53.
2. Dobson Roger (2007): US hospital patients with poor English have more serious adverse events than proficient speakers: British Medical Journal 2007; 334:335. Web.
3. Donini-Lenhoff F. G and H. L. Hedrick (2000): Increasing Awareness and Implementation of Cultural Competence Principles in Health Professions Education: Journal of Allied Health 29: 241–45.
4. Robins L S et al. (1998): Improving Cultural Awareness and Sensitivity Training in Medical School: Academic Medicine 73 (Supplement 10, 1998): S31–S34.
5. Sobralske Mary, PhD, RN. Ellen Raney, MD Brian Carino, MD (2008): Ethnic Diversity, Language Barriers, and Interpretation in a Children’s Orthopedic Clinic: Washington State University; Intercollegiate College of Nursing.
6. Woloshin S. (1995): Language Barriers in Medicine in the United States: Journal of the American Medical Association 273: 724–28.

Introduction

An action plan is a detailed strategy that outlines activities required to attain a specific objective. It is also referred to as organized steps to execute a certain task effectively. Telehealth uses electronic information and communications expertise to improve long-distance medical services, patient and professional clinical-related training, and public wellbeing management (Van Galen et al., 2019). Some of the technologies employed include the Live video streaming, mobile data applications, and social network platforms (Van Galen et al., 2019). This work details an action plan used to establish telehealth in a rural community.

A Background Check on Each Site

Since there have not been specialist services for a long time, the first thing to do will be to visit the intended site one by one to assess their suitability and readiness. The latter will enable me to write down all the resources and improvements needed for the project’s success. This phase will involve informing all the workers and the community stakeholders on the new development. The latter will guarantee that all the employees are involved and feel that they are part of the program.

Central Communication Point

Telehealth is all about communication to get the right specialists to the patients in need. 24-hour running information exchanging base will need to be established. The above-mentioned procedure will ensure that nothing is missed between the patient and the specialist (McClellan et al., 2020). The point will be for setting an appointment with both the physicians and the clients. This section is important because the doctors are not based in the community and will need to see the sick and go back to their main employment areas. Matching the ailing individuals and the physicians’ schedules will be a vital assignment for workers here.

Resources and Necessary Equipment

The health centers will need to have treatment equipment since doctors will only come with their expertise. My colleagues and I will select the necessary machine compulsory for issues that facing our patients. This is the stage of mobilizing resources through the State government, health administration committee, or non-governmental organizations to acquire enough necessities (Pollard et al., 2017). We will also ensure that hospitals are hygienic for these exercises by ensuring that the available rooms are cleaned. In other clinics, we might also require constructing new building for this purpose since most of them are fully utilized.

The Specialists Schedules

The rural community needs various types of special treatment; people have various conditions that need different specialists. Some of the needed medics in our community include; gastroenterologists, endocrinologists, dermatologists, cardiologists, anesthesiologists, surgeons, psychiatrists, pediatricians, radiation oncology, obstetrics, gynecologists, and dermatologists, among others (Van Galen et al., 2019). It is impossible to mobilize resources for all the professionals to come to a clinic in one day, each will need a day or two in a day. A calendar will be formulated for all physicians throughout the month for better planning.

Community Mobilization

After we put every aspect of the medication to occur has been put in place, the last assignment will be to inform the community of what is available and when. Educating the residents will help maintain the schedules and ensure that the people get the services they need on time (McClellan et al., 2020). The citizens will also be required to register stating their issues, with a list of individuals in need of acre we will source for enough physicians for each category.

Conclusion

The action plan, as highlighted above, can only be successful with the right mobilization of resources and all stakeholders. We will ensure that our program works by working together as physicians, hospital administrators, and other healthcare stakeholders, including the community. Though this is a new health delivery model in our society, we have prepared ourselves for high and lows. Telehealth is an opportunity to improve services for our people.

References

McClellan, M. J., Florell, D., Palmer, J., & Kidder, C. (2020). Clinician telehealth attitudes in a rural community mental health center setting.Journal of Rural Mental Health, 44(1), 62-73. Web.

Pollard, J. S., Karimi, K. A., & Ficcaglia, M. B. (2017). Ethical considerations in the design and implementation of a telehealth service delivery model.Behavior Analysis: Research and Practice, 17(4), 298. Web.

Van Galen, L. S., Wang, C. J., Nanayakkara, P. W. B., Paranjape, K., Kramer, M. H. H., & Car, J. (2019). Telehealth requires the expansion of physicians’ communication competencies training.Medical teacher, 41(6), 714-715. Web.

Nurse practitioners (NPs) understand that the healthcare sector continues to encounter various challenges. New changes and advocacy initiatives are needed to help address such issues and transform the outcomes of more patients. The state of California has introduced a new bill that is in line with the latest report by the California Future Health Workforce Commission. Such a bill will only become law if all key participants and stakeholders complete their roles efficiently. This paper describes some of the leadership and activism efforts that NPs need to undertake and contribute to the passage of new health bills.

Background

California has presented new legislation aimed at granting NPs full practice privileges and authority. The move will reduce the existing barriers and ensure that more citizens receive timely, personalized, and reliable medical services. While the bill is capable of allowing NPs to practice to the full extent of their skills, training, and knowledge, much needs to be done throughout the legislation process (Weinmeyer, 2016). The passage of new laws depends on the involvement of all key partners, information sharing, and decision-making. Forming the biggest percentage of caregivers, nurses can be on the frontline to advocate for new changes and laws that can transform their experiences. Such a move will make it easier for them identify existing barriers to practice and apply the best strategies to address them.

Action Plan

NPs who want to influence policy decisions and procedures in their respective states and support the passage of new laws should have a powerful action plan. Nurses should begin by identifying the right advocacy obligations. This approach will help them identify what they should do to transform practice and meet the changing needs of their patients. This strategy should be combined with the concept of lifelong learning. Specifically, they will complete additional studies and learn more about some of the emerging proposals in the field of healthcare (Ellenbecker & Edward, 2017). Most of these reports offer suggestions for improving practice and mitigating some of the challenges in practice, such as nursing shortage. The initiative will also make it easier for them to become aware of their region’s legislative process. This knowledge will guide them to follow the right channels, sensitize the right groups, and make the much needed decisions.

NPs can consider various initiatives that can help them achieve their advocacy goals. For instance, Salmond and Echevarria (2017) indicate that such professionals can make direct calls or write e-mails to individuals who make key voting decisions. The Californian example reveals that nurses could identify and communicate with specific legislators and update them about how the new bill is capable of transforming the experiences of both patients and nurses. When NPs liaise with more policymakers, chances are high that they will vote in favor of such a bill and eventually make it a state healthcare law (Ellenbecker & Edward, 2017). Additionally, nurses can write detailed letters to some of the politicians and inform them about the specific policy change or agenda.

The American system provides the relevant frameworks and guidelines that can help NPs become part of the legislative process. For instance, some professionals in the healthcare field can run for office and promise the electorate how they would be willing to introduce and support new bills. The ultimate should be to present laws that can revolutionize the overall healthcare sector in a positive manner (Weinmeyer, 2016). Those who follow such a route will achieve their goals much faster and present expert opinions to their respective colleagues. Such an effort is capable of contributing to the passage of progressive laws in the healthcare sector.

The political arena forms the primary basis for dictating the manner in which policy proposals and ideas eventually become laws. NPs should ensure that their initiatives, practices, and advocacy efforts are in accordance with their region’s political arena. This knowledge will guide them to identify the right channels and people who are more informed about the anticipated goals (Balestra, 2017). This approach can ensure that the relevant outcomes are recorded in a timely manner. Such professionals can also offer additional suggestions for streamlining the process and supporting the delivery of the anticipated goals.

On top of the outlined strategies, individuals working in the healthcare sector could engage in additional practices to support the delivery of timely results. For example, grassroots outreach programs form the backbone of most of the advocacy efforts (Ellenbecker & Edward, 2017). Specifically, the involved participants will identify new ways to sensitize legislators and work directly with those who might be in support of the targeted bill (Ellenbecker & Edward, 2017). This strategy streamlines the process, addresses some of the possible challenges, and maximizes chances of success. The participants should, therefore, ensure that they work within the stipulated legal guidelines.

Every state has a chapter dedicated or focusing on the needs of NPs. Practitioners can work with their respective state chapters to coordinate visits and events that can result in increased awareness. For example, they can arrange for visits to inform legislators about the proposed bill, the outcomes it intends to achieve, and its possible implications for the future of nursing practice (Salmond & Echevarria, 2017). Additionally, nurses can decide to engage in lobbying activities and select specific dates. A good example is the CANP Lobby Day that is celebrated annually on 13th May. Similar days are common in different states across the country and help colleagues come together and pursue their legislative agenda.

Finally, modern technologies are transforming a wide range of fields and activities. Nurses can capitalize on such developments to take their policy ideas to the next level. The emergence of social media networks and the Internet could make it possible for NPs to spread information and maximize awareness (Weinmeyer, 2016). This effort can ensure that more people collaborate and focus on the best ways to pursue their common goals. In the present case, they can support progressive bills until they pass to become laws in their respective regions. The use of the available outreach information can support the process and eventually ensure that the relevant results are realized (Ellenbecker & Edward, 2017). Consequently, more nurses can be empowered to work efficiently and eventually achieve their maximum potential.

Conclusion

The above discussion has identified advocacy as an evidence-based practice that all NPs should take seriously. This practice is capable of increasing awareness for emerging bills and ensuring that more political leaders support. The use of proper communication channels, lobbying, social media, and group-based platforms can help more professionals contribute to the success of emerging bills. Such an outcome will eventually ensure that more patients receive sustainable, personalized, and timely medical support.

References

Balestra, M. (2017). Telehealth and legal implications for nurse practitioners.Health Policy, 14(1), 33-39. Web.

Ellenbecker, C. H., & Edward, J. (2017). Conducting nursing research to advance and inform health policy. Polity, Politics, & Nursing Practice, 17(4), 208-217. Web.

Salmond, S. W., & Echevarria, M. (2017). Healthcare transformation and changing roles for nursing. Orthopedic Nursing, 36(1), 12-25. Web.

Weinmeyer, R. (2016). Safe patient handling laws and programs for health care workers. AMA Journal of Ethics, 18(4), 416-421. Web.

Detailed information for Scenario and Anecdotal note

Objective: To provide organized care that promotes client well being

During the clinical experience placement in the South Eastern University nursing unit, Cameron was observed to be disorganized in taking the relevant records of the patient, a 67-year old female admitted with a diagnosis of GI bleeding. From the instructor at the beginning of the video, it is evident that the patient’s emergency room documentation and missing orders had already been filed. Upon being provided with the vital data about the patient, he does not inquire of the reason for the patient’s pending laboratory tests. Some of the vitals that needed proper clarification entail blood pressure which is 186/45, respiration which is 21, OTUSA which is 95%, and her temperature, which is 36.4 degrees Celsius.

The disorganization of Cameron continues throughout the clinical day, with the student making various trips back and forth between the nursing unit and the patient room without valid reasons. Assessment is done but in a flustered manner as Cameron was still behind schedule for assessment plans. Similarly, the student fails to create a good rapport between him and the patient, thus making it difficult for him to carry out an organized assessment. Cameron lacks confidence in the type of medication that the patient will need when asked by his instructor about the provision of blood units. The student also lacks a proper documentation system for the patient’s records on matters related to hemoglobin content.

Cameron also makes unnecessary movements in the hospital, thus making him waste much time that would be used in addressing the patient’s needs. Similarly, various incidents of confusion from the student would result in poor patient outcomes (Othman et al., 2019). For instance, after completing the blood check, he was about to hang the blood units even before analyzing a set of vital signs of blood pressure. The patient also appears to have a hyperactive valve cell; her AIV is in the left AC and has a value of 18 gauge with an average ceiling running at 125ml/hour. Throughout the provision of the patient’s vitals, Cameron appears to be focused on recording the assessment rather than asking other questions on the patient’s progress. Therefore, the student will be required to explore the healthcare setting for full implementation of the solutions suggested below.

However, the student carries himself with much decorum and respect for Mrs. Phyllis, which is evident from how he introduces himself to the patient. He gives the patient preference for the type of treatment she would prefer. The student also possesses relevant nursing anecdotes that highlight the profession of nursing strength. For instance, the student adopts efficient communication skills with the patient while focusing on patient-centered care (Schuelke et al., 2019). In addition, the student possesses empathy, which has helped create a trusting connection with Mrs. Phyllis by focusing on the patient’s point of view. With such an approach, the student has gained a deep insight into how Mrs. Phyllis is coping and her general feeling. The student has also demonstrated self-awareness which has significantly helped him incorporate excellent personal management and achievement in his service to Mrs. Phyllis.

Action Plan

Despite proving to be an excellent upcoming nurse, Cameron also illustrated various weaknesses that need to be addressed to fully attain the required skills and knowledge related to the nursing profession. A sample action plan that has been developed to address his weakness has been tabulated below:

Non-Compliance Plan

Suppose the student does not comply with the above action plan to improve his nursing experience; there will be minimal chances of passing this course. Similarly, any inability to comply with the said action plan may result in emergency safety challenges, such as setting priorities and carefully correlating care with previous courses’ knowledge. In addition, non-compliance in addressing his confusion weakness may result in risky situations resulting in the patient’s death.

Legal and Ethical Consideration

Like any other medical professionals, nurses are forced to work in an environment prone to drastic changes concerning pressure in containing cost, advancement in medical sciences, and advancement in technology (Farmer & Lundy, 2017). With such rapid changes, nurses have to make the relevant decisions regarding the ethical and legal implications of any situation that they engage themselves in. Some of the critical legal and ethical considerations evident in this scenario entail the balance of providing excellent medical care to the patient despite high pressure, thus ensuring proper utilization of time and resources (Ingham-Broomfield, 2017). This is evident from the fact that the nursing student is forced to work under pressure from the pains of the assigned patient to ensure efficient and proper patient care for Mrs. Phyllis.

Another ethical consideration that has been made in providing guarding of the patient privacy, which has been manifested from the way the nursing student closes the curtains before beginning the necessary assessment and proper documentation of the patient situation without any form of leaks to the public via social media platforms (Koskenvuori et al., 2019). In addition, the nursing student does not leave the patient’s paper charts in public places and only engages with the patient directly without involving other third parties. The nursing student also tries to avoid any conduct with the patient that would suggest any form of sexual misconduct as it is against the law and ethics in the nursing profession (Farmer & Lundy, 2017). He tries to request the patient to do different kinds of stuff that entails sensitive parts, such as the abdomen.

References

Farmer, L., & Lundy, A. (2017). Informed consent: Ethical and legal considerations for advanced practice nurses. The Journal for Nurse Practitioners, 13(2), 124-130. Web.

Immonen, K., Oikarainen, A., Tomietto, M., Kääriäinen, M., Tuomikoski, A. M., Kaučič, B. M.,… & Mikkonen, K. (2019). Assessment of nursing students’ competence in clinical practice: a systematic review of reviews. International Journal of Nursing Studies, 100, 103414.

Ingham-Broomfield, R. (2017). A nurses’ guide to ethical considerations and the process for ethical approval of nursing research. Australian Journal of Advanced Nursing, The, 35(1), 40-47.

Koskenvuori, J., Numminen, O., & Suhonen, R. (2019). Ethical climate in the nursing environment: a scoping review. Nursing Ethics, 26(2), 327-345.

Othman, E. H., Shatnawi, F., Alrajabi, O., & Alshraideh, J. A. (2020). Reporting nursing interventions classification and nursing outcomes classification in nursing research: A systematic review. International journal of nursing knowledge, 31(1), 19-36.

Summary

Successful implementation of a project implies having staff and leaders change their work practices. In this project that aims to minimize polypharmacy, needless medications, and excessive medications, considerations are put on the nurse leader’s role for each stage of the project (Sganga et al., 2015). The roles include effective planning, task coordination, overseeing the project, inspiring team members, and decision-making, which are essential to establishing a plan of action for project implementation. Behavioral change has numerous steps more than educating staff and leadership to change. However, as a nurse leader, to effect change will require persuading staff to change.

Leadership involves many aspects, including setting a strategic direction, creating a shared sense of purpose, and modeling behaviors required to be seen in others. Effective leadership transcends something more mundane, like getting individuals to do things they would rather not do but benefit the organization (Udod & Wagner, 2018). Since leadership involves the work of change, the top priority as a nurse leader will entail overcoming the natural tendency to resist change by persuading staff. Therefore, getting staff to change will begin by asking them to do something easy (Weiss et al., 2019). When they agree to the request and accomplish the objective, they will develop a sense of confidence and commitment, making them more enthusiastic about agreeing to the more extensive or subsequent request. The path to significant change will be paved by many small steps building on each other. In addition, to help the team accept and assist in pushing change, it will require following particular steps. The steps include stating the change, listening and acknowledging feedback, using emotional intelligence, explaining the why, defining clear roles, providing training, and rewarding acceptance.

Actions Taken by A Nurse Leader

Communication with Stakeholders

Stakeholders’ support will be critical to the success of the intervention project. Stakeholders must be involved during every project phase to build support, offer design suggestions, and participate in the evaluation and continuous quality improvement plans. Nurse leaders will communicate regularly to secure, manage expectations, and maintain stakeholders’ support (Hayes, 2022). According to Blair (n.d.), nurse leaders with set the tone for their entire department about communication with each other, including physicians, doctors, families, and patients. The communication will include everything from project intervention progress updates to conflict resolutions in the facility (Weiss et al., 2019). Communication with stakeholders will be maintained through developing strategies to enhance and monitor how every staff works together.

Training

Growing as a nurse leader mainly implies focusing on an exceptional skill set leading to nursing leadership, such as guidance. A nurse leader will use motivational and interpersonal strategies to lead the group and individual nurses under them (Sudsawad, 2007). According to Weiss et al. (2019), through mentorship, a nurse leader will cultivate an environment of continual development and learning within the project intervention. In addition, the nurse leader will offer education to staff on the importance of using the correct drugs for particular diseases and avoiding needless medication.

Budget

Budgeting is a delicate task for nurse leaders who are accountable and responsible for the project budget. As Weiss et al. (2019) stated, improper budgets result in a lack of coordination increasing costs and inefficiency in achieving set objectives. The operating budget will be the key driver of all levels of project management (Garfinkel & Mangin, 2010). Operating budget will help in the efficient and smooth operation to meet set objectives and goals. Budgeting will influence patients’ use of drugs and the degree and provision of clinical care. Resources will be provided to avoid the misuse of drugs and develop a budget within the healthcare organization that includes cash, capital expenditure, and operating cost to realize a successful project (Hayes, 2022). Nurse leaders will ensure a proper budget and collaborate with nursing staff on the unit and other parties in healthcare to realize quality care provision.

Change Management

Becoming a change coach is an essential concept in the field of nurse leadership as it controls a combination of plans and skills to influence the mindset of teams, their capabilities, and a person’s talents. Nurse leaders advocate change by underscoring the positive elements of new organizational features, procedures, and technology. In this project, change management will entail the adoption of electronic options to assist drug-drug and drug-disease reactions before issuing prescriptions. The change also primarily involves the minimization of polypharmacy cases and needless medications among patients (Sganga et al., 2015). To realize change, nurse leaders will engage in hands-on training and communicate effectively with staff, expressing challenges, reservations, and successes they witness to administrators, providing foresight and expertise to recognize change in medications.

The change management theory relevant to this project is Kurt Lewin’s change model. The model entails three steps: unfreezing, transition, and freezing (Hayes, 2022). Lewin’s model will be relevant to the project because it will help make changes more smoothly as it identifies the need for change and establishes its readiness. The theory will support nurse leaders through the transitions and recognize areas of resistance and strengths before implementing change.

Authority

Nurse leaders play vital roles in executive and administrative positions. They demonstrate authority by carrying out diverse managerial and administrative functions entailing human resources and financial management, quality of care standards, organizational goals, and patient and nurse advocacy. Nurse leaders will make decisions about project implementation, organize staff training, prepare budgets, and foster professional development (Weiss et al., 2019). They will also oversee nursing units and ensure nurses follow set procedures and protocols that maintain high-quality care and patient safety regarding drugs. A nurse leader will represent nurses in meetings with other executive leaders and advocate for patients, working to promote their satisfaction and a safe environment.

References

Blair, T. (n.d.). Leading the way: A new vision for local government. Institute for Public Policy Research.

Garfinkel, D., & Mangin, D. (2010). Feasibility study of a systematic approach for discontinuation of multiple medications in older adults: addressing polypharmacy. Archives of Internal Medicine, 170(18), 1648-1654. Web.

Hayes, J. (2022). The theory and practice of change management. Bloomsbury Publishing. Web.

Sganga, F., Landi, F., Ruggiero, C., Corsonello, A., Vetrano, D. L., Lattanzio, F., & Onder, G. (2015). Polypharmacy and health outcomes among older adults discharged from hospital: results from the CRIME study. Geriatrics & Gerontology International, 15(2), 141-146. Web.

Sudsawad, P. (2007). Knowledge translation: introduction to models, strategies and measures. Austin, TX: Southwest Educational Development Laboratory, National Center for the Dissemination of Disability Research.

Udod, S., & Wagner, J. (2018). Common change theories and application to different nursing situations. Leadership and Influencing Change in Nursing.

Weiss, S. A., Tappen, R. M., & Grimley, K. (2019). Essentials of nursing leadership & management, (7th ed.). FA Davis.

Creating an action plan and following it strictly, especially if it entails new routines for your body, is challenging and needs discipline. The action plan that I created was difficult for the first few days. As a result, I came up with some steps to help me apply the action plan, and I managed to effectively maintain discipline in implementing it for the rest of the period.

The first action I came up with was to write a reminder on my phone and set the alarm to notify me when the time to sleep was near, mostly three hours earlier. I made sure when the alarm rang, I started preparing for bed. This step gave me enough time to eat two hours before and take a shower to decompress from my day. The reminder was effective in maintaining discipline, and as a result, my body switched and adapted to the new routine.

Furthermore, I always made sure that I ate a balanced diet for my health and drank enough water. When a new routine is introduced to the body, there are many struggles, which may lead to procrastination at times (Hoeger et al., 2018). For that reason, one should eat a healthy meal to reduce resistance. The exercises in the morning made me sweat a lot, which called for drinking much water to cater to the loss through sweating. In addition, my body, at first was very stiff when exercising. I felt heavy, and this left me with so much fatigue after I had completed the exercise. The balanced diet meal and plenty of water helped heal the stretched muscles and make them more flexible and willing to go further.

Moreover, by taking a balanced diet and plenty of water, I made sure that I took a shower to reduce fatigue when I exercise in the morning. During the first two days, I realized that fatigue makes one lose the morale of willing to go further with the action plan. The remedy for this challenge in the morning was taking a relaxing shower, and I felt good for the rest of the day. This intervention was much help as I always wanted the day to end faster, so I can exercise again and take a relaxing shower. The action plan became more interesting as the days progressed.

In the beginning, I viewed the action plan as a difficult task for me. When the two weeks elapsed, I realized that I was even supposed to reduce the time limit to one week because my body was adapted to the new routine. My performance was good though there were some challenges, which I managed to overcome. I tried my best and maintained discipline, which helps me to implement the action plan successfully.

I was successful in achieving my goal for the two weeks that I had planned. I have been consistent with working at least five days a week and walking my dog at least two miles a day. I learned that discipline is fundamental, and I kept myself focused on the set schedule. I would push myself constantly, but at the same time, I stayed mindful and listened to my body. I believe that this is not a race; I am also more conscious of my health and the people around me. Taking this medical self-assessment course, I appreciated the importance of exercising. I now understand health behaviors within myself and others, improve health habits, reduce risk factors, and acknowledge the importance of healthy living, which made me push harder in exercising.

At the end of the two weeks, I felt much different. My body has become more flexible, and I can walk miles without struggling. In addition, I can work out for an hour without stopping. I cannot feel as heavy as I was feeling, and I think my lifestyle has increased in standards. There are no unintended consequences other than waking up earlier, but I still struggle to go to bed early.

There are much unexpected benefits that I have gained through this action plan. My body became more flexible than before, and I can do the exercises without any strain. Additionally, I lost the extra weight, and my appetite increased. Although there were many positives, I also had some challenges. For example, I found difficulty balancing a new business, work, employees, and my new lifestyle.

Overall, to improve my future outcomes, I would modify my action plan by adding some aspects. First, I would introduce rewards upon completing a particular task on time. The prizes will help motivate me to maintain self-discipline. Additionally, to improve my overall wellness for me, I will set aside one day every week to visit the gym to enable me to raise my workout experience and break the monotony of exercising in one place. I would also add a rule of not using the phone at night to make it possible to sleep early.

Reference

Hoeger, W. W., Hoeger, S. A., Hoeger, C. I., & Fawson, A. L. (2018). Lifetime physical fitness and wellness. Cengage Learning.

Reflection is an essential part of the practitioner’s activity as it aims at stimulating the professional to improve the skills and learn how to deal with difficult situations (Eaton 2016). When reflection is applied, the practitioner becomes more experienced and confident of his/her abilities (Jasper 2006, Blair & Deacon 2015, Howatson-Jones 2016). A reflective person is open to communication in the way of gaining the best outcomes for the patients. Critical thinking is considered an inseparable part of reflective practice (Lillyman & Merrix 2012, Thompson & Pascal 2012). Inability to accept criticism may be an obstruction to reflective practice as it often presupposes admitting one’s fault and being ready to improve one’s methods. On the other hand, being too much critical is also bad as it undermines the practitioner’s confidence in his/her knowledge and skills (Ely & Scott 2007).

The reflective cycle proposed by Gibbs is considered one of the most efficient models (Ely & Scott 2007, Scaife 2010, Bulman. & Schutz 2013). It includes the following stages: description, thoughts and feelings, evaluation, analysis, conclusion, and action plan (Ely & Scott 2007, p. 187). I shall apply this model when describing my reflection on the mentioned practice issue. The type of knowledge informing the practice is personal experience (Freeman& Sturdy 2015).

Reflection on an Identified Practice Issue

Description

I noticed that two of my colleagues often neglected the rules of hand hygiene. They did not always wash their hands or change gloves when switching from one type of work to another. Sometimes they disrespected the hygiene requirements because of the lack of time (for instance, when there was a patient delivered by an ambulance, and there was no time to spare because the person’s life was in danger and every minute was crucial).

However, frequently such disregard took place when there was no hurry (for example, they did not wash their hands after using the bathroom). After a careful decision-making process, I decided to let the charge nurse know about the situation. However, I also warned my colleagues about my decision and asked them to be more responsible. My resolution gave them time to realize their mistakes before being invited to the charge nurse’s office and asked for the explanation of their behaviour. I also asked the charge nurse not to be too harsh on them but at the same time let them know that even a minor misconduct in a health service work may lead to damaging outcomes for the patients.

Thoughts and Feelings

As a health practitioner, my first concern was about the patients’ wellbeing and health. If a medical worker disregards the simplest hygiene requirements, he/she may disobey other rules which are much more crucial and the breaking of which may lead to dramatic outcomes for the people’s health. I felt rather disappointed and disturbed. I did not know how to find a way out of the situation which would satisfy all the stakeholders. I realized that the patients’ health is the first and foremost concern for me as a health practitioner. At the same time, I understood that I needed to maintain a good relationship with my colleagues. This situation frustrated and upset me. I had a feeling that my colleagues did not value the people’s lives to the necessary extent. I also had a hard time thinking that I would set them up by telling the charge nurse about the incidents.

Evaluation

The experience allowed me to make both positive and negative conclusions. I realized that I did a good thing when I noticed the situation and decided to take measures. My basic professional instinct is taking care of the patients, and in this case I was thinking about their health and wellbeing. On the other hand, I was disturbed because I was doing some harm to my colleagues by pointing out their wrong behaviour to the charge nurse. It would have negative outcomes on them. However, taking into consideration all the sides of the situation, I think I did the right thing. Maybe my colleagues will be punished, but they must not forget about their highest priority as healthcare practitioners. This case will teach them a lesson. I hope that they will be more considerate about their hygiene in future. Additionally, this minor case will teach them to be cautious about major cases. As a result, they will remember that someone’s health is in their hands, and they must conform to all the rules in order to provide the patients with the best care.

Analysis

This situation taught me several lessons. First of all, it is vital to remember one’s responsibilities under any circumstances. Even though I did not want to hurt my colleagues, I was thinking of the patients’ welfare in the first place. I realize that as notice someone’s misbehaviour, other people might see mine. Therefore, this case taught me to be more cautious about the rules and obligations. Another thing I took from this issue is that it is necessary to keep on good terms with one’s colleagues. While I disapproved of some practitioners’ misconduct, I did not just go and report on them. I explained the situation to them and emphasized the significance of their correct behaviour. I did everything possible to maintain the favourable relationships with my co-workers.

Conclusion

There were two other resolutions I could have made. I could either tell my colleagues that I noticed their wrong conduct and ask them to stop, or I could complain to the charge nurse and not warn the people why she would have a conversation with them. In the first case, I would most likely earn the co-worker’s respect and hear a promise that such situations would never repeat. However, I could not be sure about their conscientiousness in future. In the second case, my colleagues would consider me a traitor who reported on them without explaining the situation. These two decisions are worse than the one I made because they only view the case under one angle. My resolution was the most suitable and included consideration of every side of the situation.

Action Plan

In future, if an identical situation occurs, I will develop a similar strategy. If I see any violations which may put the patients’ wellbeing under threat, I will let the authorities know about that, but at the same time, I will reveal my intentions to the colleagues involved. I believe that this is the most suitable way out of such practice issue. Patient’s health is my priority interest, but I also want to have good relationships with my co-workers.

References

Blair, E. & Deacon, A. (2015) A holistic approach to fieldwork through balanced reflective practice. Reflective Practice 16(3), 418-434.

Bulman, C. & Schutz, S., (eds.) (2013) Reflective Practice in Nursing, 5^th edn. Wiley-Blackwell, Chichester.

Eaton, C. (2016) “I don’t get it,” – the challenge of teaching reflective practice to health and care practitioners. Reflective Practice 17(2), 159-166.

Ely, C. & Scott, I. (2007) Essential Study Skills for Nursing. Elsevier, Edinburgh.

Freeman, R. & Sturdy, S. (2015) Knowledge in Policy: Embodied, Inscribed, Enacted. Policy Press, Bristol.

Howatson-Jones, L. (2016) Reflective Practice in Nursing, 3^rd edn. Sage, Los Angeles.

Jasper, M. (2006) Professional Development, Reflection, and Decision-making. Blackwell Publishing, Oxford.

Lillyman, S. & Merrix P. (2012) Nursing and Health Survival Guide: Portfolios and Reflective Practice. Routledge, London.

Scaife, J. (2010) Supervising the Reflective Practitioner: An Essential Guide to Theory and Practice. Routledge, London.

Thompson, N. & Pascal, J. (2012) Developing critically reflective practice. Reflective Practice 13(2), 311-325.