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Strategic Leadership and Future Delivery Models – C163

Type: Coursework

Subject: Nursing Leadership Course

Subject area: Nursing

Education Level: Maters Program

Length: 10 pages

Referencing style: APA

Preferred English: US English

Spacing Option: Double

Instructions:  create a multimedia presentation or business plan document in which you do the following: note: if a multimedia presentation is selected, presenter notes must be included for each slide in order to fully cover the level of explanation, analysis, and discussion necessary. a. provide the hcahps scores for a hospital of your choice. note: refer to the web link to find hcahps scores for various hospitals. b. analyze the hcahps scores of your chosen hospital by doing the following: 1. compare the scores to state and national averages. 2. compare the scores to two other hospitals in the region. 3. compare the survey response rates to two other hospitals in the region. 4. describe the hospital's demographic patient population and services provided. 5. discuss how the following environmental and community factors could potentially influence hcahps scores: a. cultural dynamics b. educational dynamics c. socioeconomic dynamics 6. explain potential short- and long-term financial impact on the organization. a. discuss potential impact on quality outcomes. c. discuss the potential cause of the chosen hospital’s hcahps scores. d. develop an organizational strategic plan to improve the chosen hospital’s hcahps scores throughout the organization by doing the following: 1. explain how organizational change can help improve the chosen hospital’s hcahps scores. 2. discuss the structure (i.e., framework), process (i.e., actions), and outcomes of the strategic plan. 3. discuss how you would incorporate evidence-based practice and shared governance to improve organizational quality. 4. explain methods you would use to incorporate concepts of shared accountability among patients, medical providers, payers (e.g., insurance providers, medicare, medicaid), and personnel. 5. explain methods you would use to incorporate technology trends within healthcare. 6. explain methods you would use to improve the care delivery system, including the topics of quality, cost, access, and patient-centered care. 7. explain methods you would use to improve financial stability. e. develop an implementation plan and timeline for the strategic plan you developed in part d by doing the following: 1. discuss key roles and responsibilities of stakeholders. 2. discuss how you would ensure stakeholder accountability and involvement. 3. discuss any training staff would need in order to implement the plan. 4. outline a timeline for implementation of your plan, including periodic review checkpoints to measure progress. f. discuss the process you would use to evaluate the success of the strategic plan, including the following: • method of measurement that would be used • evaluation of the timeline • method of analysis 1. discuss how you would involve key stakeholders in the evaluation process. 2. explain how the evaluation results will be communicated internally and externally. g. when you use sources, include all in-text citations and references in apa format. note: when using sources to support ideas and elements in an assessment, the submission must include apa formatted in-text citations with a corresponding reference list for any direct quotes or paraphrasing. it is not necessary to list sources that were consulted if they have not been quoted or paraphrased in the text of the assessment.


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Strategic Leadership and Future Delivery Models – C 163

Student’s Name

Institutional Affiliation

Course Number: Course Name

Instructor

Date Due

Strategic Leadership and Future Delivery Models – C 163

A. HCAHPS of Mount Sinai Hospital

Patient Experience

Hospital Score

Compared to State  Averages

Compared to National Averages

The percentage of patients reporting that their nurses always communicated well

75%

78%

81%

The percentage of patients reporting that their doctors always communicated well

79%

78%

82%

Patients  reporting that they always received help as soon as they wanted

59%

63%

70%

Patients reporting that the staff always explained medicines before giving it to them

56%

60%

66%

Patients reporting that their room and bathroom were always clean

65%

71%

76%

Patients reporting that the area around their room was always quiet at night

47%

53%

62%

Patients reporting that Yes, they were given information about what to do during their recovery at home

83%

85%

87%

Patients who strongly agree they understood their care when they left the hospital

49%

49%

54%

Patients who gave their hospital a rating of 9 or 10 on a scale from 0(lowest) to 10(highest)

66%

66%

72%

Patients who reported YES, they would definitely recommend the hospital

69%

66%

72%

Source: https://www.medicare.gov/care-compare/details/hospital/330024?id=73aa0e6b-cf01-45c9-ae36-bdd6889a28cc&city=New%20York&state=NY&measure=hospital-patient-surveys

 From the above table, it is evident that Mount Sinai hospital average scores are below national and state averages. However, patients who gave the hospital a rating of 9 or 10 and those who strongly agreed that they understood their care when they left hospital is similar to the state’s average but lower that the national average. Accordingly, the score for patients who are willing to recommend the hospital is higher than the state average but lower than the national average.  Thus, the hospitals need to invest resources in enhancing the experience of its patient population.

. Comparing Mount Sinai Hospital HCAHPS Scores to Two Other Hospitals in the Region

Patient Experience

Mount Sinai Hospital

Hackensackumc Mountainside

Montefiore Mount Vernon Hospital

The percentage of patients reporting that their nurses always communicated well

National Average : 81%

State Average:78%

75%

75%

76%

The percentage of patients reporting that their doctors always communicated well

National Average :82%

State Average:78%

79%

77%

77%

Patients  reporting that they always received help as soon as they wanted

National Average :70%

State Average; 63%

59%

55%

59%

Patients reporting that the staff always explained medicines before giving it to them

National Average :66%

State Average: 60%

56%

55%

48%

Patients reporting that their room and bathroom were always clean

National Average :76%

State Average: 71%

65%

71%

76%

Patients reporting that the area around their room was always quiet at night

National Average : 62%

State Average:53%

47%

49%

57%

Patients reporting that Yes, they were given information about what to do during their recovery at home

National Average :87%

State Average: 85%

83%

82%

79%

Patients who strongly agree they understood their care when they left the hospital

National Average : 54%

State Average: 49%

49%

43%

37%

Patients who gave their hospital a rating of 9 or 10 on a scale from 0(lowest) to 10(highest)

National Average : 73%

State Average: 66%

66%

63%

58%

Patients who reported YES, they would definitely recommend the hospital

National Average :72%

State Average:66%

69%

63%

52%

Source: https://www.medicare.gov/care-compare/compare?providerType=Hospital&providerIds=330086,310054,330024&city=New%20York&state=NY

Comparing the Hospitals Response Rate

According to the scores, Montefiore Mount Vernon Hospital scores the highest (76%) in patients reporting effective communication with nurses. Mount Sinai and Hackensackumc Mountains scored 75% each. However, Mount Sinai Hospital scored the highest in effective communication between doctors and patients with a score of 79% compared to 77% of the other two hospitals. Mount Sinai Hospital and Montefiore Mount Vernon Hospital scored 59% in patients reporting that they always received help as soon as they wanted.  However, Hackensackumc Mountains scored 55%.  Mount Sinai Hospital scored 56% in patients being satisfied with staff explaining medicine before giving them. Hackensackumc Mountains scored 55% while Montefiore Mount Vernon Hospital scored 48% in this area. 

Montefiore Mount Vernon Hospital scored the highest in having the area around their patients room always quiet at night(57%) and their rooms and bathroom are always clean(76%) followed by Hackensackumc Mountains(49% and 71%), and Mount Sinai(47% and 65%).  Mount Sinai Hospital had the highest score in patients reporting that they were given information about what to do during their recovery at home (83%), strongly agreed that they understood their care when discharged from hospital (49%), getting a rating of 9 or 10(47%), and recommending the facility to friends (69%) compared to Hackensackumc Mountains and Montefiore Mount Vernon Hospital as shown by the table above.

Mount Sinai Hospital's Demographic Patient Population and Services Provided

Mount Sinai Hospital offers a variety of health services supported by expertise and advanced medical discipline. Patients visiting the facility access various clinical care treatment and specialties. Some of the services offered include access services, addiction services, adolescent medicine, allergy and immunology (Mount Sinai, 2018). Other services are behavioral health, ambulatory care, bloodless medicine, breast health, cancer care, comprehensive health program, dentistry, diabetes services, gastroenterology, urgent care, and pathology services. 

Mount Sinai Hospital takes care of a diverse patient population. Situated in New York City, the organization caters for patients from diverse ethnic and racial communities.  It offers services to those with unlimited resources, the uninsured, and the homeless (Mount Sinai, n.d). For this reason, the organization has an Office for Diversity and Inclusion (ODI) to support the facility’s adoption of the diversity and inclusion principles. The facility considers its diversity and inclusion approach as the primary driver of innovation and excellent in the provision of competitive health and medical education, healthcare service delivery, and research. 

How the Following Environmental and Community Factors Could Potentially Influence HCAHPS Scores

Cultural dynamics

The comprehension of patient’s perspective is crucial to providing patient-centered care. Patient attributes like language preference, ethnicity, and race determines their view of the accessed care (Herrin,  Mockaitis, & Hines, 2018).  Taking the demographic profile of the patient population into consideration is necessary to facilitate effective communication between healthcare providers and patients. Therefore, cultural competence enhances effective communication with patients from diverse backgrounds. Additionally, cultural competence ensures that healthcare workers educate patients in a language they understand and ensures that patients understand exactly what they are told. The resultant effect is improved patient satisfaction and reduced rates of readmission after discharge. Therefore, culture influences HCAHPS Scores.

Educational dynamics

Various factors influence the effectiveness of patient’s education. According to Murdock & Griffin (2013), patient education influences their satisfaction levels.  Patient who are offered relevant information and at a level they can comprehend boost their satisfaction level with the quality of care offered. Additionally, well-informed patients trust their healthcare providers and are satisfied with care delivery. Thus, patient education influences HCAHPS scores because it impacts hospital reimbursements, patient care, and satisfaction.

 Socioeconomic dynamics

 A patient’s socioeconomic status determines their perceived value of accessed care. According to Arpey, Gaglioti, & Rosenbaum (2017), individuals of low socio-economic status are likely to have reduced life expectancy, poor self-reported health, and suffer from multiple chronic conditions than their counterparts. Accordingly, they receive fewer medications and diagnosis tests and have restricted access to healthcare services because of coverage and cost. Therefore, hospitals serving a diverse patient population are likely to have lower rating because of perceived bias in healthcare access.

Potential Short-and-Long Term Financial Impact on the Organization

The Potential Impact on Quality Outcomes

Patient’s satisfaction is an indicator of healthcare quality.  Patient satisfaction determines medical malpractice claims, patient retention, and clinical outcomes. The measure also affects patient-centered, efficient, and timely delivery of the safe and quality care. Therefore, the quality of care accessed by patients determines facility quality outcomes and patient’s satisfaction levels

 Potential Cause of the Chosen Hospital’s HCAHPS Scores

The chosen hospital’s HCAHPS Scores is patient’s satisfaction. According to the survey results, the hospital score on various measures is below the state and national average. Some of the potential causes of the poor score might be attributable to ineffective communication between healthcare workers and patients.  Similarly, the scores might be attributable to patients not receiving healthcare as soon as they want.  The patients might not have understood the explanation offered to them regarding their medications because the education plan does not reflect their learning styles and level of education. The score may also be as a result of the patient not receiving adequate information on what to do after their discharge. As a result, they do not understand their care following discharge. Addressing these areas is necessary to reflect the states and national average.

Organizational Strategic Plan to Improve Mount Sinai Hospital Patient Satisfaction HCAHPS scores

Patient experience is important in the healthcare sector. Therefore, providing excellent services remains a priority for healthcare organizations. High quality services results in good reputation and financial stability for the organization. Therefore, Mount Sinai Hospital should design a training program for its staff to improve its HCAHS scores. Patient survey factors concentrate on attention to detail and communication. Since Mount Sinai Hospital nurses and other healthcare providers interact with clients, the training should focus on enhancing their communication effectiveness and cultural competence because the facility caters for a diverse patient population. Other strategies that the organization should implement to improve its HCAHS scores are: Establishing a peer to peer evaluation, emphasizing patient-centered care, involving the patients in their care plan, and allowing staff to design a plan of action to improve HCAHPS without leaders’ involvement. The changes will help improve patient’s satisfaction because the nurse will provide services that reflect their patients’ distinct needs and preferences. Additionally, patient’s involvement in care delivery will result in greater satisfaction.

The Structure, Process, and Outcomes of the Strategic Plan

Structure

Process

Outcomes

  • Kurt Lewin's Change Model: Unfreezing, Changing and Refreezing
  • Training health care workers to enhance their communication effectiveness and delivery of cultural competent care
  • Patient’s involvement in the design of their care
  • Staff to design strategies to address areas with low HCAHPS score\
  • Organization to enhance access to resources to facilitate  change process implementation
  • Enhanced patient experience and satisfaction
  • Improved quality of care
  • Improved patient, physician, and nurse communication
  • Good reputation and enhanced financial performance of the facility 

How I will Incorporate Evidence-Based Practice and Shared Governance to Improve Organizational Quality

Blending evidence-based practice and shared governance model is beneficial for the hospital and nurses. For instance, shared governance allows nurses to take leadership role and drive change through evidence-based practice process. Nursing leadership supports an environment that facilitates effective change process. Therefore, to incorporate evidence-based practice and shared governance, I will do the following:

  • Implement continuous training for organization staff  to enhance individual’s transition into the decision-making role
  • Develop instruments that help leaders assess the outcome of shared governance and make necessary adjustments to ensure that shared governance results in improved patient outcomes
  •  Improving nurses’ solid decision-making skills,  encouraging them to critique research studies, ask questions, and assess research findings
  • Creating an environment that promotes autonomous decision-making and critical thinking
  • Valuing empowerment processes like shared leadership, shared governance, and shared decision-making

Overview of the methods I would use to incorporate concepts of shared accountability among patients, medical providers, payers, and personnel

The methods I will use to incorporate the concepts of shared accountability among key stakeholders are:

  •  Engaging patients in their care and health choices, prevention and wellness decisions
  • Redesigning care by using technology like Teleservices and streamlining care management
  • Financial incentives alignment by designing payment models that focus on quality services and meeting individual care goals.

Methods I Would Use To Incorporate Technology Trends Within Healthcare.

Technological advancements are transforming the healthcare sector.  Technologies like artificial intelligence, Electronic Health Records, software development and apps are being integrated into the healthcare system to improve care. Although there are challenges associated with integrating technology in healthcare delivery, it is evident that technology improves healthcare quality. Therefore, I would use the following methods to incorporate technology trends within healthcare

  • Involve healthcare workers in the implementation of the technology to minimize resistance
  • Training and coaching the technology user. Lack of skills undermines technology integration in the healthcare sector. Healthcare facilities are characterized by workers from different generations.  Unlike their counterparts, baby boomers lack the tech-savvy skills required to use technology. As a result, they are slower to incorporate technology in care delivery. However, through coaching and training, they will find the technology user-friendly
  • Piloting and testing the new technology before its adoption and use to note any malfunction

Overview of the Methods I would Use to Improve the Care Delivery System

Achieving the Triple Aim of lower costs, better health, and better care and improving care delivery is the primary goal of all healthcare system. Therefore, I will use the following strategies to improve the care delivery system.

  •  Focusing on providing patient-centered and affordable care to a diverse patient population
  • Designing systems for care coordination and care management to enhance patient satisfaction with the quality of care delivered
  • Incorporating social health and behavioral health determinants in care delivery
  • Establishing high-reliability and safety healthcare system
  • Aligning care delivery  with community needs
  • Using technology to collect data about patient needs and health status, and analyze the information obtained to set priorities and deliver care that mirrors the patient need.

Methods I will Use to Improve Financial Stability

Financial stability is a major challenge for health care organizations. Intense rivalry between insurers and increased number of new patients compels hospitals to increase revenue and reduce their operating expenses.  Therefore, I will take the following measures to improve my facility’s financial stability.

  •  Enhance patient satisfaction and experience by offering  quality care and  excellent customer service
  • Invest in health information and technology systems to improve care delivery
  • Promote wellness to ensure that the staff is healthy to provide exceptional service to the patients and communities while reducing hospital expenses. A healthy workforce  reduces absenteeism rates, projects a positive image, and improves patient care
  •  Sustaining a competitive edge in the healthcare sector by enhancing patient’s access to care in nontraditional and convenient locations

Developing an Implementation Plan and Timeline for the Strategic Plan

Key roles and responsibilities of stakeholders in implementing the Strategic Plan 

Stakeholders

Roles and Responsibilities in Implementing the Strategic Plan

Physicians

  • Ensuring that patients access adequate and quality care
  • Control the rising healthcare expenses by minimizing referrals and tests
  • Coordinate with other healthcare providers to enhance patient’s experience

Patients

  • Participate in the design of their care plan
  • Communicate the challenges they encounter  while accessing care
  • Highlight areas of improvement in care delivery

Nurses

  • Provide patient-centered and cultural competent care
  • Educate patients about their condition and side effects of their medication
  • Provide patients with instructions to follow at home after discharge
  • Collaborate with other staff to meet the needs of the patient

Healthcare Administrator

  • Provide  resources to enhance the implementation of the plan

 

How I will Ensure Stakeholder Accountability and Involvement

Stakeholder involvement and accountability is necessary to enhance successful implementation of the change project. I will take the following measures to ensure stakeholders’ accountability and engagement:

  •  Ensuring that all stakeholders contributes to the implementation of the plan
  • Making engagement part of the change initiative
  • Project leader to be responsible for driving stakeholder involvement and accountability
  •  Facilitating two way communications to minimize communication breakdown. A variety of communication channels will be used to facilitate effective communication between stakeholders

Training that Staff Will Require to Implement the Plan

Cultural competence training will be required before implementing the plan because the facility accommodates patients from diverse cultural backgrounds. The training will focus on knowledge and skills that value inclusion and diversity, how to react to cultural differences, and improve staff cultural awareness. The training is expected to result in increased cultural skills and understanding, improved health outcomes and patient satisfaction.

 Timeline for Implementing a Plan and Periodic Review Checkpoints to Measure Progress

Activities

Timeline

Identify reasons for performing below average in patient satisfaction survey

Three week

Impacts of the low scores and individuals Affected

One Month

Designing a Communication Strategy

One week

Providing Cultural Competent Training

Six weeks

Implementing a support Structure

One month

Measuring the Change Process

Continuous

Periodic Review

Quarterly

The Process I will Use to Evaluate the Success of the Strategic Plan

The success of the strategic plan will be measured based on improved patient satisfaction with the quality of services offered at the facility. The timeline will be evaluated based on the achievement of various milestones within the set deadline.  The stakeholders will be involved in the evaluation process through the use of interviews and surveys. The process will allow them to offer their view about the changes implemented, their effectiveness, and suggestions for modification.  The evaluation results will be communicated internally using board meetings, Memos, and the organizational newsletter. For external stakeholders, the evaluation results will be communicated through the company’s website and the newsletter.

References

Arpey, N. C., Gaglioti, A. H., & Rosenbaum, M. E. (2017). How socioeconomic status affects patient perceptions of health care: a qualitative study. Journal of primary care & community health, 8(3), 169-175.

Herrin, J., Mockaitis, K. G., & Hines, S. (2018). HCAHPS scores and community factors. American Journal of Medical Quality, 33(5), 461-471.

Mount Sinai. (2018). The Mount Sinai Health System: Community service plan implementation strategy. https://www.mountsinai.org/files/MSHealth/Assets/HS/Files/CSP%20MSH%20MSQ%20FINAL.pdf

Mount Sinai.(n.d). Office for diversity and inclusion. https://www.mountsinai.org/about/diversity

Murdock, A., & Griffin, B. (2013). How is patient education linked to patient satisfaction?. Nursing2020, 43(6), 43-45