Nurses as Leaders
Essentials of Advanced Nursing Practice Field Experience
Years ago, the role of the nurse was limited and easily described. In today’s world, the nurse’s role is complex and occurs in diverse settings with a broad client population. Often, nurses must combine several professional roles to manage the full range of their responsibilities. Nurses also manage roles that have limited domains of actual authority but large domains of influence (and vice versa). Master’s level nurses are now required to be leaders: whether formally or informally.
For this task, you will select a healthcare organization in your area to analyze and then prepare a consultative change recommendation paper. As part of your analysis, you will interview a nurse leader in the selected organization. Your consultative change recommendation paper should be 7–10 pages and in APA style. Although you are only submitting this paper to WGU as part of your requirement for this course, you should prepare this document as though you would present it to the executive board of the organization you analyzed.
In order to complete this assessment, you must carefully review and closely follow the attached “wqt2 performance assessment guidelines” document.
You are a nursing consultant who has been assigned to analyze a healthcare organization in order to identify a change or improvement needed by the organization. In your analysis, you will use external measures such as HCAHPS, scores, patient metrics, community needs, and comparisons to other facilities in area. After your analysis, you will write a consultative change recommendation to present to the executive board of the organization.
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.
Professional communications is a required aspect to pass this task. Completion of a spell check and grammar check prior to submitting your final work is strongly recommended.
You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. 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.
A. Write a consultative change recommendation paper (suggested length of 7–10 pages) by doing the following:
1. Identify the purpose of the consultation and provide a summary of the consultation process.
2. Describe the organization.
Nurses as Leaders
Leadership plays an integral role in effective nursing care. In the healthcare sector, the role of nurses has been expanding with their recognition as leaders in the patient care process becoming evident. Accordingly, the process of nursing in the contemporary environment comprises of the implementation of goal-centric interventions with the aim of improving the patient health status. In the changing environment, there has been the recognition of nurses for their distinctive roles as leaders. Nurses operate within a mandate of coordinating and motivating care teams, patients, and families with a focus on enhancing the patient’s well-being. Therefore, the need for adapting to the leader role has become a fundamental aspect of concern towards ensuring adequate care prevails in any organization. Specifically, from the analysis of Mayo Clinic, it has become evident that the need for nurses to undertake a leadership role is fundamental since they are at the forefront of healthcare delivery. Development of an environment whereby there is improved safety and quality in the healthcare systems as per Mayo Clinic has become a focal point towards the encouragement of nurses to take a leadership role. Therefore, this paper will examine various approaches for Mayo Clinic to improve its safety and healthcare systems through adoption of nurses as leaders.
Purpose of the Consultation and Summary of the Consultation Process
Promotion of safety and ensuring quality healthcare systems is imperative for any organization. From the analysis of Mayo clinic, it has become important to promote safety and effectiveness in the use of the various healthcare systems. To accomplish the initiative, the organization has focused its efforts on the Clinical Nurse Specialist as the leader towards the accomplishment of the goal (Kelly, Wicker & Gerkin, 2014). Therefore, as a consultant, the aim is to obtain the relevant information on the need for changes in the healthcare system management and development of the standards of operations for the nurses in a leadership role. As such, the analysis of the patient metrics regarding satisfaction and dissatisfaction should develop a base towards the evaluation of the operational dynamics of the organization (Melnyk, et al., 2012). Further, the interview of the nurses, especially the Clinical Nurse Specialist should develop insight on how the organization can improve its health safety and develop a health quality system of care. Therefore, the consultation process will comprise of the following fundamental phases:
- Seeking approval from the management to undertake an interview of the various nurses in the organization ten days before the initial interview
- Undertaking a firsthand overview of the organization through observation and comprehension of the organizational operation
- Undertaking the main consultation with the nurses through collaboration and involvement of Clinical Nurse Specialist to comprehend the organizational safety and health quality systems put in place
- Giving recommendations to the management on the most important aspects of the organization that ought to be changed
The adoption of the consultative process is to develop an avenue whereby a step by step initiative is established towards understanding how Mayo clinic undertakes its health safety and health quality system management. As such, the involvement of the nurses is to establish an environment whereby there is openness in the communication process. Further, promotion of inclusivity in the consultation process is imperative to develop and ensure mutually beneficial outcomes in the policy implementation process.
Description of the Organization
With over 130 years of operation, Mayo clinic has been a beacon of operational excellence in the healthcare sector (Zeballos-palacios, et al., 2016). As such, the organization has focused its operation towards generating ways towards working together with the community and its employees to achieve the highest level of care possible. With an organizational mission of inspiring hope through the promotion of healthcare and well-being, the organization has been scaling the heights of healthcare excellence through adoption of diverse operational strategies. The development of the core values that determine the organizational operations such as integrity, compassion, and respect have ensured that the organization dominates the healthcare sector. However, with the transition to new technologies and implementation of online operations, the promotion of healthcare safety and promotion of healthcare system quality has become a central focus of the organization (Zeballos-palacios, et al., 2016). Despite adhering to the high standards of professionalism, ethics and individual responsibility, the use of technology in the organization has been a daunting prospect especially in ensuring the privacy of the patients is not infringed. Therefore, the need for an in-depth overview of safety and healthcare quality systems has become mandatory for sustainable operations.
Primary needs of the Population Served by the Organization
At the core of the needs of a patient or population served by a healthcare organization is the sustenance of well-being. As a clinic with over 50000 specialists, doctors and nurses, Mayo has been focusing on promoting health and well-being of the patients that it services (Zeballos-palacios, et al., 2016). Through adopting the “patient comes first” motto, the organization has been at the forefront towards promoting health care of the patients through meeting their primary needs (Zeballos-palacios, et al., 2016). Therefore, among the primary needs of the population that Mayo clinic serves to include:
- Physiological needs that are inclusive of food, exercise, and sleep
- Essential needs such as life-saving measures through adopting state-of-the-art technology to promote the well-being of the patients
- Protective needs that are inclusive of safety, security and available staff to meet the care needs
- Communication needs through the emphasis on a direct communication environment whereby there is no discrimination in the communication process
- Exercise through the provision of an open environment whereby the patients can have normal flow and movement to ascertain their well being
The focus of the organization is towards ensuring an enabling environment prevails both for its patients and nurses. Therefore, there are the established basic needs that the organization believes that it should meet for the population it serves. Apart from the above needs, the organization also adopts corporate social responsibility through offering periodic free testing for various ailments for the local community.
Nurse’s Leader Role
Mayo clinic appreciates that there are rapid changes occurring in the healthcare sector. The focus on mitigating or ensuring that there is alignment with the changes happening has led to the organization adopting new models of operation. As such, one of the approaches towards ensuring that nurses take a leadership role is care coordination. The organization, through its Clinical Nurse Specialist, has given the individual the mandate to coordinate and ensure that the delivery of services to the patients is effective and efficient. In reference to, AACN, (2013) the care coordination and transition management role for the Clinical Nurse Specialist denotes the emphasis on information management. Accordingly, there is a need for comprehensive strategies that assure the patients coupled with families in regards to information relay. In the healthcare setting, seamless information flow is fundamental towards ensuring quality health care prevails (AACN, 2013). Therefore, through the Clinical Nurse Specialist, there have been significant strides towards ensuring that the care coordination and transition management process prevails effectively in the business.
Characteristics of the Organization
Mayo clinic believes in three stakeholders as integral towards their success. Physicians, nurses, and patients are at the core of the organizational operations. As such the company adopts the culture of transformational leadership in which there is openness in the decision-making process (Zeballos-palacios, et al., 2016). Therefore, from the analysis of the organization, three of the fundamental characteristics include:
Physicians are the leaders: the company incorporates an avenue whereby the leadership is in the hands of the physician-led committees. Whereas a majority of the clinics adopt a professional administrator, the organization believes in the use of physician. As per the committee’s leadership, there is the emphasis on the prospect that the physician leadership is important since it ensures that the operations are grounded by first-hand information about the patients. In reference to Zeballos-palacios, et al., (2016) the physicians in the organization take a rotating role in the committee to ensure effective leadership.
Integrated medical record in management of information: the organization believes in its ability to promote safety through the use of an integrated method of record management. There are the partnership and coordination of the various departments (Zeballos-palacios, et al., 2016). From the laboratory to radiology and pathology, there is a focus on efficiency in information relay. The healthcare system adopted, as per the organization is geared towards ensuring that patient tests, physician results, laboratory tests, and reports are in one room.
Focus on a tri-monthly review of performance: after every three months, the organization adopts comprehensive analyses of its performance. The main focus of the review is to generate comprehensive information about the operational dynamics of the business (Zeballos-palacios, et al., 2016). Through performance review, the organization obtains first-hand information on the progress regarding health care quality and the safety systems put in place.
Recommendation for Organizational Change Based on Analysis
It is imperative for Mayo clinic to comprehend that there is a need for involvement of the nurses in the leadership process. As such, in the promotion of safety and healthcare quality, the prospect that the nurses operate at the health system level should be a motivating factor towards the involvement of the nurses. From the above analysis, the features of the organization reveal that it centers its leadership on the physician without the involvement of the nurses (Kelly, Wicker & Gerkin, 2014). Therefore, in a changing healthcare sector whereby there are litigations and privacy issues in the instance that confidential patient information is in one room, there is a need for the involvement of nurses in the decision-making process. To address the organizational shortcomings in regards to safety and management of patient information, the main recommendations include:
- Setting up a position for the Clinical Nurse Specialist in the physician committee
- Involving the Clinical Nurse Specialist in the information management process
Justification on how the recommended change will address organization’s weaknesses and the community needs
Focusing on nurses as leaders in the organization can be a powerful tool towards shaping the organizational, operational structure. In a changing healthcare sector where safety and health quality are integral, there is a need for Mayo clinic to adopt the nurses into their leadership process. Nurses as leaders in the organization will provide deep experience coupled with comprehension of the health delivery process on a first-hand basis. Despite the noble initiative towards ensuring patient information is less than one room, the management fails to conform to the HIPAA Act regarding patient information (Kelly, Wicker & Gerkin, 2014). As such, there are no guidelines about the process in which the patient information is shared. Using the nurses will provide a new perspective towards promoting the information management and care coordination process. Of utmost importance will be the need to establish safety guidelines in regards to the information use process.
Identify a national benchmark of performance and describe a plan to measure the effectiveness of your recommended change
To determine the effectiveness of the organization in its changes adopted it is imperative to focus on the various tools available. The use of the National Hospital Quality Report (NHQR) provides the organization with a benchmark towards the analysis of the performance (Keys, 2014). As such, the benchmark provides information about the top performing States and the values regarding patient care. There is the establishment of various values or criteria towards the development of measures that the organizations should meet. In the analysis of the success of the recommended changes the three aspects of benchmark in the promotion of quality and safety in the healthcare systems should comprise of:
- Far away from benchmark: when the level of quality does not achieve 50% of the set benchmark
- Close to benchmark: value of the organizational performance lies between 50 and 90%
- Achieved benchmark; the level of performance is above 90%
The promotion of nurses to the
leadership role is fundamental for successful outcomes. From the analysis of Mayo
clinic, it has maintained success through its distinctive business model that
is centered on its patients. Through its physician led the committee in
leadership, it has been at the forefront towards ensuring healthcare delivery.
Nonetheless, in regards to safety and health care quality systems, the various
strategies such as information management exude shortcomings such as the
prospect of privacy infringement. Therefore, the involvement of nurses in the
policy formulation process is a recommendation towards handling the minor
details that can be negatively impactful on the organization.
American Association of Colleges of Nursing (AACN). (2013). The essentials of master’s education in nursing. 2011. New York: Pearson.
Kelly, L. A., Wicker, T. L., & Gerkin, R. D. (2014). The relationship of training and education to leadership practices in frontline nurse leaders. Journal of Nursing Administration, 44(3), 158-163.
Keys, Y. (2014). Looking ahead to our next generation of nurse leaders: Generation X Nurse Managers. Journal of nursing management, 22(1), 97-105.
Melnyk, B. M., Fineout-Overholt, E., Gallagher-Ford, L., & Kaplan, L. (2012). The state of evidence-based practice in US nurses: critical implications for nurse leaders and educators. Journal of Nursing Administration, 42(9), 410-417.
Wilmoth, M. C., & Shapiro, S. E. (2014). The intentional development of nurses as leaders: A proposed framework. Journal of Nursing Administration,44(6), 333-338.
Zeballos-Palacios, C., LeBlanc, A., Hess, E. P., Tilburt, J.,
Wyatt, K., Boehmer, K., … & Montori, V. M. (2016). Case Study:
Interventions to create better conversations at the Mayo Clinic. Shared decision making in health
care: achieving evidence-based patient choice. 3rd ed. Oxford University Press,
Appendix 1: Interview Questions for Nurse Leader
What are your roles in the organization as a Clinical Nurse Specialist?
As a Clinical Nurse specialist, the main roles entail overseeing the operations of other nurses, communicating with the top physicians on various issues and ensuring that there is coordination in the care process.
Are you involved in the decision making process in the organization? Yes or No
If either answers, comment how or why not
No, the decision making process comprises of the physician committee that is involved in running the operations of the organization.
What is the organizational standpoint on nurses as leaders?
Despite communicating on the need for nurses as leaders, the implementation process has been gradual and filled with bureaucracy
Have there been any initiatives towards promoting nurses as leaders? Yes or no? No
What are the changes that should be adopted by the management that require nurse’s input?
Among the changes include:
- Any issue involving the management of patient information
- Performance evaluation metrics
- The adoption of new approaches towards ensuring quality in healthcare system