Organizational Leadership and Interprofessional Team Development

Order Description
Directions
ORGANIZATIONAL LEADERSHIP & INTERPROFESIONAL TEAM DEVELOPMENT

Competencies:
7006.01.01: Leadership Concepts and Theories – The graduate evaluates leadership practices that support accountability and integrity within an organization.
7006.01.02: Systems Theory and Change Theory – The graduate relates systems theory and change theory to the design, delivery, and evaluation of healthcare.
7006.01.03: Role Development and Effective Interprofessional Teams – The graduate analyzes effective leadership strategies within the context of the interprofessional team.
7006.01.04: Business and Economic Principles and Practices – The graduate identifies the impact of business and economic principles and practices, and regulatory requirements on the provision of healthcare.
7006.01.05: Contemporary Healthcare Leadership Issues – The graduate analyzes the impact of contemporary healthcare trends and practices on the delivery of healthcare.
Introduction:

Healthcare is a complicated system that includes unique economic processes, regulatory requirements, and quality indicators that are not found in traditional business settings. Therefore, developing unique skill sets relating to organizational leadership and interprofessional team development is essential for leaders within the healthcare industry at any level. As the complexity within the healthcare industry increases, it is important to understand the comprehensive approach to patient care management across the continuum and how the concepts of organizational leadership and team development support leaders in creating a patient-centric environment.

The purpose of this assessment is to provide a framework through which you can experience and understand the unique leadership concepts within healthcare and understand the implications of business and regulatory requirements in providing patient-centered care. You will use system theory, change theory, self-assessment approaches, and team development concepts to design a strategy to increase patient-centered care. Using leadership concepts and theories, you will ensure a sustainable model of healthcare delivery throughout the changing healthcare system that considers future trends, evidence-based practice, and regulatory expansion.

For this assessment, you will use the attached “Patient-and Family-Centered Care Organizational Self-Assessment Tool,” to analyze how patient- and family-centered the healthcare setting is. This form will guide you in evaluating this healthcare setting for strengths and weaknesses in patient-centered care attributes. Based on your analysis, you will create a strategy to bridge those areas and increase patient-centered care.

Requirements:

Your submission must be your original work. No more than a combined total of 30% of the submission and no more than a 10% match to any one individual source can be directly quoted or closely paraphrased from sources, even if cited correctly. Use the Turnitin Originality Report available in Taskstream as a guide for this measure of originality.

The rubric provides detailed criteria for evaluating your submission. You are expected to use the rubric to direct the creation of your submission. Each requirement below may be evaluated by more than one rubric aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course.

Note: Any information that would be considered confidential, proprietary, or personal in nature should not be included. Do not include the actual names or other personally identifiable information of people or stakeholders involved. Fictional names should be used. Also, agency-specific data, including any financial information, should not be included but should be addressed in a general fashion as appropriate.

A. Analyze how business practices, regulatory requirements, and reimbursement impact patient-centered care within a healthcare organization.
B. Complete the attached “Patient-and Family-Centered Care Organizational Self-Assessment Tool” (PFCC) for a healthcare organization.
Note: The PFCC tool is a subjective tool used to assess the organization you have chosen.
1. Describe the healthcare setting you used in the PFCC.

2. Using the completed PFCC tool, describe the strengths and/or weaknesses of the organization for each domain.
C. Identify one area of improvement from the weaknesses identified in part B2.

1. Create a strategy to increase patient-centeredness in the organization by addressing the weakness from part C.

a. Discuss how you would apply either system theory or change theory in the development of your strategy to address the chosen weakness.

2. Discuss the financial implications of implementing this strategy.

3. Discuss the methods you will use to evaluate the effectiveness of your strategy.
D. Create a multidisciplinary team by identifying the following:

• potential members that will assist you in implementing the identified strategy

• The role of each team member

1. Discuss how cultural diversity within the team supports patient-centered, culturally competent care.

2. Using one of the leadership theories below, discuss the leadership style you would utilize in developing your team:

• transactional leadership

• transformational leadership

• emotional leadership

• traditional leadership

3. Discuss how the team will work together to implement the strategy to address the weakness identified in part C1.

4. Describe how the team will communicate the identified strategy and intended outcomes to the healthcare organization.

5. Describe a specific tool you could use to develop the team’s self-assessment skills.
E. Acknowledge sources, using APA-formatted in-text citations and references, for content that is quoted, paraphrased, or summarized.

Solution

Organizational Leadership and Interprofessional Team Development

Business Practices in Patient and Family-Centered Care

Business Practices

Business practices, regulatory requirements, and reimbursement impact patient-centered care within organizations in many ways.  Organizations make a great effort to focus on how they can include a patient in their care.  They want to efficiently and effectively provide methods that will include a patient and their family.  Business practices include changing visiting hours geared toward patient-centered care.  Allowing younger visitors to see a newborn sibling without a hassle is an example of changing patient visiting policies.

Regulatory Requirements

Regulatory requirements force healthcare organizations to provide services that comply with regulations to keep an organization up and running to avoid their license or accreditation from being taken away.  An example of a regulatory requirement is having the proper licensing of physicians, nurses and allied personnel to work in a facility.  Professions like this must have documented education, passed state tests and documentation of continuing education.  If these things are not maintained a regulatory agency like the Joint Commission can cite an organization which is then a reportable offense that could affect reimbursement for that facility.   

Reimbursement

Reimbursement is critical because it determines the revenue a provider receives for their services.  A wide range of services is required by healthcare organizations for payments to be granted to them from organizations, such as the Centers for Medicaid and Medicare Services.  CMS focuses on improving patient safety and outcomes through financial penalties for lack of participation or poor performance (Roussel, 2013).  The CMS makes organizations look for ways to improve their services to provide patient-centered care.

Patient and Family Centered Care Tool (see attached)

Setting Description

Cedars Sinai Health Systems (CSHS) is a non-profit healthcare organization with 886 Licensed beds, and a Level I Trauma Center.  It is in the heart of Los Angeles, CA on the edge of Beverly Hills.  Cedars serves 256,075 patients in their medical network which includes 49.6% Hispanic/Latino, 19.7% Caucasian, 18.0% Black/African American, 10.1% Asian, 0.2 American Indian/Alaska Native, 0.1% Native American/Pacific Islander and 2.4% Other. Cedars also provides a vast variety of patient services including Neurosurgery, Orthopedic and Cardiac just to name a few.  There are 2,166 physicians and 3,363 nurses that are employed in the CSHS (Cedars Sinai, 2018).  Cedars focus is providing quality care to every patient every time.

Strengths and Weaknesses of the Organization       

Domain	Strength	Weakness
Leadership/Operations	Provides a clear statement of commitment to patient/family-centered care.  This is in the organization’s mission statement.	Patient/family inclusion in policy, procedure, program, guideline development, Governing Board activities. The patient/family participation is only on the governing board by giving donations to the organization.
Mission, Vision, Values	Clear mission and vision statements that express they are committed to patient-centered care. Offering compassionate care and high-value care. Leading the nation in delivering excellent clinical quality, patient safety, and service.  The Patient Bill of Rights is stated in patient’s admissions paperwork.	No weakness is present in this domain.
Advisors	Patient/Family participating in quality and safety rounds is a strong point for this organization.  It is highly recommended that family is present for morning rounds and a team gathers to discuss the patient’s plan of care and treatment.	Patient/Family serving on hospital committees and advisory councils has not been a strong point at this organization.
Quality Improvement	The CNO at this organization performs rounds daily and talks with patients and their family about their experience.  If there are any issues, it is addressed right away.	Patient/Family voicing strategic, operational aims, goals as well as participating on task forces for quality and safety are weaknesses that this organization has.  Patient/Family being part of a team for IHI, NPSF is another weakness.
Personnel	Staff and physicians are trained in hospital orientation to involve the patients and their family in their plan of care.	There is an overall weakness in this domain.  This organization does not have patients/families participate on interview teams, search committees, or welcome new staff.  They are also not involved in the job description and policies in performance appraisal process.
Environment & Design	The organization has a strong patient and family presence in interdisciplinary collaboration.  The organization provides a healing environment for the patient/family.  The interdisciplinary collaboration occurs when the patient is 1st admitted to the hospital.  All parties involved in the patient care area	There is no evidence at this organization that shows that patient/families participate in clinical design projects.
Information/Education	The organization shows strength in this domain in four areas.  Patients/families can access web portals to obtain specific resources while in the hospital, with the use of various resource rooms.  They can also email their clinician through a secure network.	Patient/families do not serve as educators/faculty for clinicians and other staff.
Diversity & Disparities	This domain shows many strengths from this organization. They report out data about race, ethnicity, and language too many to the community.  Interpreters are available by either in person or via video for patients/families. There are also programs to help minority and underserved patients.	Educational materials at appropriate literacy levels show to be a mild weakness for this organization.
Charting and Documentation	Patients/families have full access to their paper or electronic record using secure networks.	Patient/families have limitations on what they can document in their chart.  An example of this is their ability to complete their pre-registration before their doctor’s appointment or hospital admission.
Care Support	Five areas in this domain are very strong from this organization.  Patients/families can have 24/7 access, join in rounds and shift report.  Patients receive updated medication history at each of their visits.  Family presence is supported during rescue events.	Patient/families are not able to activate a rapid response system.
Care	Patient/families engage with clinicians; they are treated with respect as partners with the team.  Families are actively involved in care planning of transitions.  Pain management is a significant initiative in this organization.	No weakness is present in this domain.

Area of Improvement

The evaluation of this organization showed many strengths, but some weaknesses did exist surrounding the patient/family involvement as advisors in the organization.  An area of improvement that will be addressed is the domain of Advisors.  The element in this domain is having more patient and family involvement in advisory and committee councils. 

Improvement Strategy

The improvement strategy to be used in implementing the change will consist of a multidisciplinary team.  This team will consist of five people who are: a patient/family representative, administration representative, nursing representative, a physician representative, and a project manager.  This group was selected based on the impact their voice will have on the organization.  This multidisciplinary team will be able to bring their perspectives from their specific areas or backgrounds.  Having a patient/family representative will guide the group to what type of advisories the facility needs.  The team will focus on how having strong groups makes patient centeredness better.

System or Change Theory

The Change theory that will make this improvement work is the Lewin Change Model.  In this change model, there is a three-step process: unfreezing, moving, and unfreezing (Sullivan, 2013).  In this theory, it will help guide the team on working on the way to involve patient/families on hospital committees and advisories.  The unfreezing step will help the team brainstorm on ways to include patients/families to be a part of committee’s and advisories.  The moving step will provide the team with evidence that other organizations have been successful with including patient/family involvement on committees and advisories.  The group can use literature and data to help persuade others that have questions about the strategy change.  The third step is refreezing.  Kristonis explains that “refreezing stabilizes the new equilibrium resulting from the change by balancing both driving and restraining forces” (2005, p. 2). This step involves developing new policies and procedures for incorporating patients/families in committees and advisories. 

Financial Implications

Financial implications that the multidisciplinary team will need to take into consideration for their strategy change include the meeting time, payment to come in for the meeting, and supplies.  A designated time will need to be decided on so that no one, especially the administrator, nursing, and physician have a scheduling conflict.  Hence, they will still be required to perform their regular daily activities.  If it is decided that the meetings will take place outside of their regular hours, they will need to be compensated for their time.  As for the patient/family team member.   A parking voucher and a meal will be provided for their time.  Supplies that will be used include paper and multimedia equipment.  Paper for printing meeting agendas and the multimedia equipment will be used display presentations.  This implementation strategy will have a little impact financially. The effect would be more on everyone’s availability and commitment to the designated time of the meetings.  The benefit of this implementation is that most of the team will, for the most part, be at the facility already and will not have to come in on a day off, there will be somewhere to have their meetings and supplies will be provided by the hospital.

Method of Evaluation

By using various community outreach forums (i.e. community fairs) will assist the team with their strategy of having more patient/family involvement on hospital committees and advisories.  When the organization has community functions, a representative from the team will be present to recruit and explain the purpose of having patient/family involvement on these committees and advisories.  Our goal is to have 20 patients/families to be involved on the 10 hospital committees and advisories. The team can regroup and discuss how they will assign the patient/family members to the groups.  The group can decide post-implementation if they have enough representation for all the groups in the hospital.  A 6-month evaluation via Survey Monkey will be conducted to ask the groups how valuable it was to have the patient/family involvement on their committees and advisories.  This will determine whether the patient/family involvement was value-added to the new implementation. This will also give the team insight on possibly opening more spaces on the committees and advisories, if warranted.

Multidisciplinary Team       

Team Member	Role on the Team
Administrator	The administrator will act as a person who would have the means to provide the group will information keep them in compliance with regulatory requirements that patients/families can be involved on committees and advisories.
Nursing Educator	Provides guidance on how to develop policies and procedures for creating the patient/family committee and advisories.
Physician	Will provide insight of care through involving patients/family and get buy-in for the strategy of other physicians.
Project Manager	Will oversee meeting minutes and agendas.  They will arrange meeting places and make sure equipment is available for the meetings.
Patient/Family Representative	Will identify what committees and advisories need to be created throughout the hospital that will have patient and family representation.

Team Diversity

It is essential that the multidisciplinary team has some diversity.  As stated by Jones & Gates “Benefits of a culturally diverse workforce are reported in the literature and include improved quality of patient care, increased patient safety and satisfaction, and increased patient and nurse satisfaction.” (2017).  When we think of diversity, we think of people from different races, ethnicities, and cultures. This team should be a reflection of diversity.  With Cedars Sinai being majority a Jewish population the group should make sure they are sensitive to the culture and beliefs of this population.  The team will already know what it means to provide patient-centered care to a diverse patient population.  This will be a plus that reflects the strengths discussed earlier in this paper.

Leadership Theory

The leadership style utilized in developing the team is transformational leadership.  Sullivan states “Transformational leadership emphasizes the importance of interpersonal relationships” (2012, p. 43).  Transformational leadership works well with this implementation because it will motivate the group to inspire one another to come up with the best possible solutions to make what they are doing a success.  This leadership style focuses on merging the motives, desires values and goals of the group to come up with a common cause (Sullivan, 2012).  This leadership style addresses the domain/element for improvement for involving patient/family on committees and advisories in the hospital.  Having this incorporation supports the improvement strategy to promote patient-centered care.

Plan for Implementation of Strategy

The improvement of having patients/families involved in committees and advisories in the hospital will genuinely enhance the patient experience.  This multidisciplinary team will work together to identify what committees and advisories need to have patient/family involvement.  This will be developed through identifying what groups exist that are without representation and provide them with a way to recruit members.  The Administrator will make sure the team follows any regulatory requirements that exist that involves having patients/families on committees and advisories in the hospital.  The Nursing Educator will be responsible for gathering evidence-based information to help the team to develop policies and procedures that the committees and advisories will follow.  An example of a policy would include information that states what position a patient or family member can serve on a committee or advisory.  The Project Manager will make sure the team stays on task and meet deadlines.  They will also keep the minutes of the meetings and make sure equipment is available for the team.  The Physician will act as a lead to get buy-in from the physician group to embrace that patients/families will be involved on various committees and advisories.  The Patient/Family representative will provide input from their experiences as being either the patient or family of a patient.  They will be able to describe if they had a patient/family centered care experience.  This information will give the team the approach the need to put their plan into action.

Communication to the Organization

The team will communicate the strategy and outcome goals through a series of one-hour drop-in sessions and scheduled ones over a period of three months.  This is to ensure a large population is captured.  These sessions will include the Physician and Nursing Grand Rounds and community outreach events to inform the former patient and family members.  The highly targeted audience will be patients and family members, but all are welcome.  All members of the team will present the new strategy at the different sessions.  It will start off with a presentation providing the goal, process, new policies, and what groups were identified that needed patient/family representation. A question and answer portion will also be included in these one-hour sessions.  A power point presentation will be used to articulate the new strategy.  Handouts with contact information will be provided at the end of the session so that participants can see what the committee and advisories are in need of patient/family representation.

Tools for the Team

To have an efficient team they must be able to get along and work together.  There are various tools to assess how well a team can work together.  The tool that will be used to evaluate this team is called the DiSC profile.  The DiSC profile provides a common language that people can use to understand themselves better and adapt their behaviors with others – within a work team, a sales relationship, a leadership position, or other relationships (Discprofile, 1997-2010).  The letters in the assessment stand for and explain the following:

 D- Dominance

• Person places emphasis on accomplishing results, the bottom line, confidence
• Can be blunt
• Accepts Challenges
• Gets straight to the point

I-Influence

• Influence
• Person places emphasis on influencing or persuading others, openness, relationships
• Shows enthusiasm
•  Is optimistic
• Likes to collaborate
• Dislikes being ignored

            S- Steadiness

• Person places emphasis on cooperation, sincerity, dependability
•  Doesn’t like to be rushed
•  Calm manner
•  Calm approach
•  Supportive actions

C- Conscientiousness

• Person places emphasis on quality and accuracy, expertise, competency
• Enjoys independence
• Objective reasoning
• Wants the details
• Fears being wrong

  The assessment is an online assessment applies adaptive testing that takes 10-15 min to complete and has about 79 questions.  Once the evaluation is complete, you will receive a detailed report about your personality and behavior. You also receive tips related to working with people of other styles (Discprofile, 1997-2010) This tool will help the team recognize their personality and how they work with others with different personalities. This tool can also make the team aware of parts of their personality that they would like to improve to make their working relationships better.

Patient-centered care is becoming the expectation when you are a patient/family in the hospital.  Having regulatory implications that can affect hospital revenue and reimbursements, these facilities are going to do whatever is needed to make sure the experience is the highest expectation possible.  Having the right team in place and input from patients/families will drive the patient-centeredness care that is expected.

References

Cedars Sinai. About Us (2018). Retrieved from https://www.cedars-sinai.org/about.html

Cedars Sinai. Community Health Needs Assessment (2018). Retrieved from https://www.cedars-sinai.edu/Community-Benefit/Community-Needs-Assessment/

Disc Profile. (1997-2010). DiSC Overview. Retrieved from https://discprofile.com/what-is-disc/overview/

Jones, C. B., & Gates, M. (2007, September). The costs and benefits of nurse turnover: A

business case for nurse retention. Online Journal of Issues in Nursing

12 (3). Retrieved from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/

OJIN/TableofContents/Volume122007/No3Sept07/NurseRetention.aspx

Kritsonis, A. (2005). Comparison of change theories. International Journal of Scholarly

Academic Intellectual Diversity. Retrieved from http://transformationalchange.pbworks.com/f/Comparison+of+Change+Theories.pdf

Roussel, L. A. (2013). Management and Leadership for Nurse Administrators, 6th Edition.

Retrieved from https://wgu.vitalsource.com/#/books/9781449684440/

Sullivan, E. J. (2012). Effective Leadership and Management in Nursing, 8th Edition.

Retrieved from https://wgu.vitalsource.com/#/books/9781269402170/