As the current medical world continues to progress, it has become an integral point for hospitals to have ongoing quality improvements. This is done in a way to match the needs and desires of the patients who seek quality healthcare. Hospitals also seek to undertake quality improvement as a way of reducing infections amongst their esteemed clients. Quality improvement is a process that takes great use of the management and leadership of nursing. Thus it is highly expected that the leadership takes the first position in steering issues that regard quality improvement in nursing. It is believed that the hospital’s organizational culture plays a major role in fostering changes with respect to quality improvement. This therefore, stresses the need to deal with the arising issues in management and leadership of nursing. The leadership must therefore provide the necessary support and responsibility to ensure that quality improvements are successful (Clark, 2009). However, it is also evident that nursing is faced with various bottlenecks that would hinder quality improvements. In this case we shall focus on the clinical unit of Maryland General Hospital, Baltimore Maryland. The study shall identify an ongoing quality improvement project in this hospital. The rationale of the paper is to find out the leadership and management issues of quality improvement in nursing.
The Maryland General Hospital seeks to put up a technologically enhanced system that will help the nursing department to provide quality healthcare to its clients. The hospital realizes that with the widespread growth in technology, incorporating a patient’s system would be very helpful in meeting its organizational objectives. The proposed system is meant to provide patients information, staffing information, accounts of patients and also the patient’s satisfaction outcomes. This development is figured to help in reduction of the levels of disease infection among its clients. This is due to the fact that the hospital will have access to patient’s information and thus they will be able to control any infections for their clients. The system is developed following a management decision by the hospital’s leadership to utilize technology in nursing. As a result of the growing dynamism in handling clinical issues, the management strongly believes that this project will boost the quality of service delivery. The system is also sought to ensure that activities in the nursing department are performed at a faster rate to ensure they serve a variety of patients. Another important benefit of this proposed improvement is for the sake of self evaluation. This will be made possible through the analysis of patient’s satisfaction information that will be availed by this system.
The system will also make it easier in dealing with regular patients and all other patients since the entire patient’s information will be provided by the system. Consequently, the system will help to track the progress of patients and thus help greatly in reducing the levels of infections among their clients. Therefore, this quality improvement project will improve the efficiency of the hospital. Following the establishment of this system the hospital collected data of individual patients as they are served in the premises. This will further be analyzed through various variables. The data collection was done through simple interviews to the patients. The data was collected between the month of July and January. The data collected was to be analyzed in terms of patient satisfaction, overall falls, readmission rates and the infection prevention measures. The patient satisfaction was observed to increase and stabilize over time from July to January. The average satisfaction level over the given period was valued to be 61%. The total acute falls per 1000 patient days was evaluated at an average of 3.7. However, acute falls without injury was found to be at an average of 0.54 over that period. The average readmission rate between the period of July and January was found to be 7.92%.
The data collected on infection prevention measures was analyzed in the following criteria. The hand hygiene compliance rate over this period was found to be at an average of 90%. Data on bloodstream infections was not found and thus the average was zero. The ventilator associated pneumonia infections rate per 1000 ventilation days was also found to be at 0.13 %. The nursing staff data is already in possession of the hospital. Thus, the institution will only feed these data from their records to the new systems. The new system also organized the staff in terms of their work responsibilities and also a description of their job will be availed by the system. This was done in the quest to ensure that the nursing staffs are fully aware of what is required on their job. Consequently, this will enhance the effectiveness of the nurses on their line of duty and also ensure that they accomplish their objectives. This quality improvement initiative by the hospital is thought to improve the healthcare practice of nursing. Most importantly the system will improve the quality of service that is accorded to patients in the hospital (Feldman, 2008). The hospital will be able to analyze the level of infections and acute falls for the hospital’s clients.
Patients will also not have to undergo through lengthy queues before seeing the doctor. Hence, the time that patients take before entering the emergency department (ED) will also be reduced significantly. Furthermore, the hospital will be equipped with the patient’s information therefore improving the nurse triage process for the clients. The system will also dictate what the individual nurses will be tasked with in the hospital. Thus, all matters will be handled effectively by the staff leaving no patient unattended (Kuehn, 2008). Hence this will also ensure that the unit serves an increased number of patients thus resulting to a broader client’s base. This will consequently ensure that patients receive the best healthcare at a well managed health facility. The hospital is also confident that the system will definitely improve their performance in the provision of health care. The Center for Studying Health System Change (HSC) in its study notes that in the recent years hospitals have seen the need for quality improvement in nursing. This is attributed to the changes in the needs of healthcare and also to the current technology improvements (HSC, 2008). There has also been a proliferation of new activities which prove to be difficult to handle with the existing systems.
Thus, hospitals are tasked with the responsibility of improving the quality of their systems in order to serve the ever increasing clients. The hospitals also seek to know the levels of infections and acute care falls for their patients. However, in achieving this, the study notes that the hospital leadership and management must be fully involved. This would ensure that these initiatives are accomplished so as to improve the quality of healthcare. The study also puts across that there has been an increased demand for hospitals to make quality improvements in order to compete with other hospitals in the market (Marquis, 2009). Thus in a way to attract more clients the hospitals have to initiate quality improvement in nursing so as to enhance their competitiveness. However, the leadership plays a core role in the accomplishment of these initiatives. The study points out some of the significant formulations that must be done in order to achieve this kind of quality improvement (Rosenthal, 2007). To begin with, there must be a supportive hospice leadership which is engaged actively. Secondly, the hospital must set objectives for all the nurses which assure that quality is not compromised. Thirdly, there must be dedicated accountability amongst the individual staff.
Lastly, the management must have constant feedback with the staff to ensure the viability of the new system. In the study by Knodel, she notes that nursing departments must improve their systems in order to cope with the current health care demands (Knodel, 2009). The study elaborates that nurses need to have real time contact with information regarding their clients. This is to ensure that they effectively deliver the services to the hospital’s clients. The system also empowers the nurses in their job by ensuring that they have complete patient information. Hence, they are able to track details on patient’s infections rates and the acute falls for their clients. The study also proposes that leadership in nursing should adopt a participative management style. This would involve staffs at all levels having self evaluations and consequently providing feedbacks amongst themselves. This system also gives nurses authority and responsibility for the services rendered to the patients (Kelly, 2008). The study insists that it is the duty of the nursing leadership to provide an environment that ensures quality health care provision. These studies are relevant to this quality improvement in the sense that both of them are proposing for development of systems in the nursing. Since there has been a shift in the delivery of healthcare and also due to increased usage of technology, it becomes prudent to apply technology in nursing. The strategies provided by these previous studies can be applied by the hospital so as to ensure the success of the proposed system (Marriner-Tomey, 2009).
The implications of this quality improvement initiative will be mostly in provision of quality healthcare. Consequently, the new system would help to improve the organizational performance of the hospital which is very important. In this analysis, a lesson learnt is that, incorporating technology in nursing can be useful in improving the quality of healthcare. This also helps to enhance service delivery in the hospital (Montalvo, 2007). Furthermore, this system helps hospitals to determine the infection levels and the acute falls of patients. In conclusion, the Maryland General Hospital is undertaking a quality improvement initiative which will help to improve the value of healthcare. In this regard the nursing unit intends to put up a system that would help in ensuring that service delivery to patients is effective. The hospital aims at incorporating technology in its activities so as to support the work of nurses. It is also believed that this system will help this hospital greatly in determining the infection levels and the acute falls rates of their patients. For this improvement to bear fruits it is highly recommended that the leadership and management of the hospital must work together with other staff. This would ensure that there is constant evaluation of the system and that it delivers as per the expectations of the hospital.
References
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Feldman, H. R. (2008). Nursing leadership: A concise encyclopedia. New York: Springer Pub. Co.
Kelly, P. (2008). Nursing leadership & management. Clifton Park, NY: Thomson Delmar Learning.
Knodel, L. (2009). Nursing management. New York: McGraw-Hill Medical.
Kuehn, B. (2007). “No End in Sight to Nursing Shortage: Bottleneck at Nursing Schools a Key Factor,” Journal of the American Medical Association, 298, (14).
Marquis, B., & Huston, J. (2009). Leadership roles and management functions in nursing: Theory and application. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
Marriner-Tomey, A. (2009). Guide to nursing management and leadership. St. Louis, Mo: Mosby Elsevier.
Montalvo, I., Dunton, N., & American Nurses Association. (2007). Transforming nursing data into quality care: Profiles of quality improvement in U.S. healthcare facilities. Silver Spring, Md: Nursesbooks.org, American Nurses Association.
Rosenthal, M. (2007). “Nonpayment for Performance? Medicare’s New Reimbursement Rule,” New England Journal of Medicine, 357, (16).
The Center for Studying Health System Change (HSC). (2008). The Role of Nurses in Hospital Quality Improvement. HSC.
