Interview and Interdisciplinary Issue Identification
Capella University
NURS-FPX4010: Leading People, Processes, and Organizations in Interprofessional Practice
Dr. Khaliah Fisher-Grace
January 27, 2024
Interview Summary
This task was an excellent opportunity to understand issues within the clinical environment and their implications on safety, quality, and cost of patient care. I interviewed a colleague, who works as a nurse with over 10 years of experience working in the medical surgical unit. Interviewing a nurse provided a chance to access in-depth information on scenarios in the organization, considering the frontline roles at the bedside and organizational level.
The nurse is in charge of operations, where she oversees activities at the bedside. A qualitative interview facilitated access to in-depth details on challenges and improvements necessary to optimize care outcomes. The interviewee identified various issues including staff turnover, high patient acuity, understaffing, and patient falls as some of the primary concerns for the organization. Despite multiple calls for leaders to respond, the organization still faces massive challenges introducing improvements necessary to maximize clinical experiences. The manager also identified power distance as a challenge that limit junior staff from influencing policies and standards of care. The problem triggers ineffective communication across the facility, which limits the organization from making meaningful progress towards improving quality, safety, and cost of patient care.
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Issue Identification
The interviewee identified understaffing, which is among the persistent issues in the organization. The low staffing levels undermine efforts to enhance the quality, safety, and cost of patient care. For instance, the issue exposes nurses to compassion fatigue, turnover intentions, and reduced morale. Persistent understaffing increases workload and burnout among physicians, nurses, clinical assistants, and other professionals. With the high number of patients requiring maximum attention, safe staffing becomes a priority. The issue portrays the need for leaders to explore options such as interdisciplinary rounds, engaging student graduates, and using externship programs.
Change Theories
The care team can utilize different theories to make informed conclusions about improvements necessary to improve quality, safety, and cost of patient care. The Plan-Do-Study-Act (PDSA) model is ideal for encouraging health leaders and members of the care team to ensure change results in an improvement (Backhouse & Ogunlayi, 2020). The framework guides health leaders to assemble a team with knowledge of understaffing and related issues. The forward-thinking team has clear roles and responsibilities (McNicholas et al., 2019). The team understands the current context and processes and strategies necessary to overcome barriers that undermine access and delivery of quality health care.
Leadership Strategies to Support Interdisciplinary Solution
Competent leadership is a priority for the organization to make meaningful progress towards optimizing care outcomes. Developing effective interpersonal relations enables leaders to cultivate and promote shared understanding, trust, openness, and shared learning across the continuum (Schot et al., 2020). The transformational leader establishes unity of force and ensures that everyone aligns their behaviors and attitudes with a clear and well-communicated vision and mission. Competent leaders initiate continuous process improvement and a culture of continuous learning to initiate and achieve meaningful changes. Further, the right leaders grow team’s skills by encouraging everyone to co-create ideas and approaches for overcoming staff burnout (Rosenberg, 2019). The leaders promote a mindfulness-based clinical environment, characterized by a common culture and shared language. Shaping team behaviors is also necessary to make everyone open to change. The efforts entail empowering the less vocal team members to share suggestions. The leader listens intently and acknowledges interdisciplinary accomplishments.
Strategies for Encouraging Collaboration
The team includes a nurse manager, physicians, nurses, and clinical assistants. One strategy is health leaders showing up with commitment to create team reactions that move everyone beyond simply being a team to being a functional interdisciplinary network. The leader empowers the less vocal team members to share ideas (Schot et al., 2020). Eliminating hierarchical barriers is also necessary to promote intent listening and real-time interactions necessary for discussing understaffing and implications on quality, safety, and cost of care. Psychological safety and shared understanding is also necessary to establish and sustain a unity of force that aligns everyone around a clear and well-communicated vision and mission.
References
Backhouse, A., & Ogunlayi, F. (2020). Quality improvement into practice. BMJ: British Medical Journal, 368. https://www.bmj.com/content/368/bmj.m865
Duffy, J. R., Culp, S., Marchessault, P., & Olmsted, K. (2020). Longitudinal comparison of hospital nurses’ values, knowledge, and implementation of evidence-based practice. The Journal of Continuing Education in Nursing, 51(5), 209-214. https://pubmed.ncbi.nlm.nih.gov/32347957/
McGowan, M., & Reid, B. (2018). Using the Plan, Do, Study, Act cycle to enhance a patient feedback system for older adults. British Journal of Nursing, 27(16), 936–941.
McNicholas, C., Lennox, L., Woodcock, T., Bell, D., & Reed, J. E. (2019). Evolving quality improvement support strategies to improve plan–do–study–act cycle fidelity: A retrospective mixed-methods study. BMJ Quality & Safety, 28(5), 356-365. https://pubmed.ncbi.nlm.nih.gov/30886118/
Rosenberg, K. (2019). RN shortages negatively impact patient safety. American Journal of Nursing, 119(3), 51. https://pubmed.ncbi.nlm.nih.gov/30801322/
Schot, E., Tummers, L., & Noordegraaf, M. (2020). Working on working together: A systematic review on how healthcare professionals contribute to interprofessional collaboration. Journal of Interprofessional Care, 34(3), 332-342. https://pubmed.ncbi.nlm.nih.gov/31329469/