Reply #1 – RH
What do you personally value? What guides decision-making and forms the foundation upon which you act? List three to five and then compare and identify your hospital’s values.
The learner values honesty, accountability, and respect. Honesty allows the learner to interact with others and bolster true and meaningful interpersonal relationships. Also, accountability allows the learner to take responsibility for all decisions and outcomes within her position at the workplace. Lastly, respect allows the learner to accommodate other people’s opinions despite their variance from the norm. Also, respect allows the learner to build a workplace environment based on trust and a sense of safety and boost employee wellbeing. The learner further values integrity which is the inner compass that drives decision making and determines the course of action in personal and corporate life. The concept of integrity implies that the learner lives in alignment with her deepest values and that the learner embodies honest interactions with everyone and always keeps her word. These values align with the core values associated with the Jackson Nephrology Associates healthcare facility in Mississippi.
The core values associated with the aforementioned setting include service excellence, integrity, teamwork, continuous improvement, accountability, fulfillment, and fun. In this context, the facility focuses on service delivery that is in tandem with the current standards of care and that promises patients only what the providers can deliver. Also, the facility administrators and executives encourage team-building and collaborative efforts that bolster creativity and synergy. Also, the facility executives encourage and embody the values of accountability to meet the firm’s written and unwritten commitments toward a quality healthcare provision. These values allow the facility workers to strive for continuous improvement while attaining higher satisfaction and fulfillment scores. These values are intertwined with the values of honesty, accountability, respect, and integrity previously mentioned by the learner in this discussion. On the contrary, the values depicted by the Jackson Nephrology Associates fail to include the element of respect on the official facility website. Despite this, respect for one’s religion, opinion, and fundamental rights intertwined with individual freedom is a daily mantra for all employees in the facility.
Identify the purpose of why your hospital exists today and for the next 100 years. Distill the essence of your presence by using the performance improvement techniques asking the five whys or using a fishbone diagram to get to the root. This purpose should have inspirational meaning to those working within your hospital.
The Jackson Nephrology Associates exists to provide care to individuals with chronic and acute kidney complications and medical disorders such as end-stage renal disease. The facility will exist in the next century to provide effective diagnosis and management of kidney-associated complications. As new technologies in regard to nephrology and surgery are tried, tested, and implemented among individuals with kidney complications, the facility will adopt these technologies and utilize them to improve the quality of care provided. The essence of the learner’s presence in the facility can be distilled using the five whys approach of performance improvement and root cause analysis. The learner is part of an employee tasked to diagnose, treat and manage patients living with chronic kidney disease and related complications (the underlying problem).
- Why: The first why focusing on the aforementioned premise could be answered by stipulating why the learner is involved with patients in this capacity. In this context, employees in the facility have to abide by the hospital’s mission and values that are aligned with giving life.
- Why: The prevalence and incidence rate of individuals with chronic and acute kidney diseases and associated medical complications increased by 55% between 2016 and 2019 (Centers for Disease Control and Prevention, 2021). Among these, 15% increased prevalence rates are within Mississippi. As such, the learner essence is critical to helping these patients.
- Why: Helping patients with chronic kidney disease and associated complications is part of the Healthy People 2030 agenda towards improving public health and suppressing the burden of disease (Mager & Moore, 2020).
- Why: It is the mission of the United States Department of Health and Human Services to promote and assess the overall efforts to monitor, document, and improve the health and quality of life of all people.
- Why: To attain thriving lives full of vitality and free from possible injury, disability, disease, and mortality cases associated with chronic and acute diseases.
With a clarity of your collective purpose and value system, envision and describe with strong conviction in vivid detail your hospital 30 years from today. This should include a goal that aligns both purpose and values; when spoken others say “wow” and understand it right away.
The learner envisions Jackson Nephrology Associates firm as the best nephrology center across Mississippi, the United States, and North America. The learner further envisions working with the best nephrologists deployed in the facility and with other experts selected from the best professionals across the globe. The learner also envisions the best and most modern current and upcoming technologies in the field of nephrology being utilized at the point of care to expedite the diagnosis process and management of chronic kidney complications. The learner envisions the facility’s goal in three decades being in tandem with the elimination of health disparities, the quest to attain health equity, and sustaining a high quality of life and wellbeing among all patients. Also, the learner envisions the facility achieving these milestones in a sustainable way that involves sound business decisions that do not necessarily include the increased cost to care (Waxman, 2018).
References
Centers for Disease Control and Prevention. (2021, March 9). Chronic kidney disease in the United States, 2021. Www.cdc.gov. https://www.cdc.gov/kidneydisease/publications-resources/ckd-national-facts.html
Mager, N. D., & Moore, T. S. (2020). Healthy people 2030: Roadmap for public health for the next decade. American Journal of Pharmaceutical Education, 84(11), 84–92. https://doi.org/10.5688/ajpe8462
Waxman, K. T. (Ed.). (2018). Financial and business management for the doctor of nursing practice (2nd ed.). Springer Publishing Company.
Reply #2 – ND
Acting in the C-Suite role assigned (CEO, CFO, or CNO) identify and share with the class your hospital’s core values, core purpose, and what the future of the organization vividly looks like in 30 years. (Chapter 13 #1)
As a person in the C-Suite role, it is important to express a vision for the facility or organization. C-Suite executive leaders must be able to clearly express to all stakeholders the importance of value-based care and how it supports the future vision of the organization (Waxman, 2018). The future of healthcare could have a totally different look in 30 years. However, it is important that core values are maintained. At this student’s current facility, the core values are honesty, duty, teamwork, and respect. Each value has its own importance. Honesty requires that all employees’ interactions are with truthfulness. Honesty helps to improve patient-provider relationships. Duty requires that each employee satisfies their obligations as it applies to competent and efficient care. Teamwork suggests that everyone is working together for the common good of the patient. All employees must respect, or value, themselves, each other as well as the patients they serve. The purpose of this facility is to provide safe, effective, and efficient health care to all students, faculty, and staff in an acute care setting. The future of this facility includes enhancing services through utilizing telehealth services more, providing a more extensive psychiatric/mental health sector, and initiating billing and coding for services rendered. Previously, this facility had an agreement with The University of Mississippi Medical Center to provide telehealth services in the absence of a provider. Since hiring a full-time nurse practitioner, these outside services are no longer needed. However, providing patients with the opportunity to use in-house telehealth for non-emergent situations is currently in the discussion phase. Combining psychiatric and mental health services with health and wellness will allow patients to experience a holistic approach to health care in one location. Currently, patients are not billed for services, nevertheless, this process may be phased out soon. Increasing revenue within the facility is essential to improving healthcare outcomes and improving the physical structure of the building.
What do you personally value? What guides decision-making and forms the foundation upon which you act? List three to five and then compare and identify your hospital’s values.
I care how a patient feels. I share these same values of my facility but would like to add integrity, compassion, and accountability. Integrity proposes that I adhere to a firm code of moral values, being sound in decision-making and unwavering in my core standards. Compassion alludes to my ability to be sympathetically conscious of others’ plight and have the desire to work to alleviate or minimize their distress. I stress accountability in my facility. Everyone is entitled to make mistakes. However, when mistakes are made, they must be acknowledged and learned from. Learning from mistakes strengthens the person who made the mistake. My values are based on the scripture that encourages everyone to treat others as they would like to be treated. This is not always easy, but surely in alignment with corporate and personal values.
Identify the purpose of why your hospital exists today and for the next 100 years. Distill the essence of your presence by using the performance improvement techniques asking the five whys or using a fishbone diagram to get to the root. This purpose should have inspirational meaning to those working within your hospital.
This facility is in a remote location. The nearest facility is more than 30 miles away. The purpose of this facility is to provide safe, efficient, and effective care to a rural community of students, faculty, and staff who otherwise may not have immediate access to care. This will also be the force behind maintaining this facility for the next 100 years.
The five whys performance technique is used to troubleshoot problems by exploring cause and effect relationships (Serrat, 2017). To refine the core of my necessity, the first question addresses “why” there is a need for healthcare professionals in this isolated environment. The need is to provide a place where constituents of this population can get safe and effective healthcare in an efficient manner when needed. The second question addresses “why” this population needs care in this location. Because of the rural environment, providing quick and competent care minimizes the risk of long-term damage from not receiving care timely. If not for this facility, why would this population not receive care timely? The nearest facility is greater than 30 miles away. Why would patients come to this facility versus going to an outside facility? This facility is close, there is no out-of-pocket expense for care, and the staff is competent and proficient in the care they provide. Utilizing services provided by this facility has resulted in improved patient satisfaction, increased visibility of providers, and improved quality of life through educating patients on self-care measures.
With a clarity of your collective purpose and value system, envision and describe with strong conviction in vivid detail your hospital 30 years from today. This should include a goal that aligns both purpose and values; when spoken others say “wow” and understand it right away.
This clinic is small but very busy. Having more exam rooms would be an asset to the facility. I envision this clinic to be stellar in the provision of health care as well as in physical appearance. I envision state-of-the-art equipment, an in-house laboratory, and well-trained providers who promote overall well-being. As an added benefit, I would love to see an in-house fitness center, endorsing holistic care and an educational center to teach patients, in a group setting, the disease process and how to manage their diagnoses. Incorporating religious life, self-care, and other intramural activities would solidify the goal of providing holistic care.
References:
Serrat, O. (2017). The Five Whys Techique. In O. Serrat, Knowledge Solutions (pp. 307-310). Chicago: Chicago School of Professional Psychology. doi:10.1007/978-981-10-0983-9_32
Waxman, K. (2018). Financial and Business Management for the Doctor of Nursing Practice. New York: Springer Publishing Company.
Reply 3 – PJ
It is essential to understand the cost drivers in hospital operations and strategies that result in more efficient care delivery. According to Waxman (2018), strategic hospital leadership requires astute business and operational knowledge (Waxman, 2018). Moreover, the nurse executive wields the understanding of hospital operations and critical data points to identify and execute strategies against principal cost drivers strategically.
Waxman (2018) describes four essentials that impact hospital efficiency. These essentials include organizational vision and cultural alignment, quality care as a cost-effective strategy, advanced analytics in the human capital equation, and leveraging of technology. The author highlights that the role of the C-suite executive leaders is to articulate the organization’s vision clearly. Three requirements are needed to articulate a vision. These requirements include identifying the organization’s core purpose, a few fundamental values held as sacred, and the desired long-term future state of the organization (Waxman, 2018).
As for the quality of care strategies, value-based models view outcome measures rather than traditional methods of managing labor expenses. Therefore, the Doctor of Nursing Practice (DNP) leader must have a firm understanding of current evidence-based literature, the insight to produce a solid business case, and the political weight to influence other executives. Waxman’s essentials emphasize that the nurse leader must possess the knowledge and skillset to utilize data and evidence proactively to inform decision-making processes.
What do you personally value, and what guides decision-making and forms the foundation upon which you act? The personal values of this writer include integrity, honesty, respect, equity, trust, and commitment. These values guide decision-making and form the foundation upon which action is taken. The assignment for this week’s discussion asks you to compare your personal values with your hospital values. In addition, a comparison will be made with the regulatory organization for which this writer is employed.
The agency’s mission is to protect the public by regulating the practice of nursing, which aligns with the vision of exemplary nursing care for all. The agency’s values include integrity, agility, and equity, which are also in alignment with this writer’s values. We act in good faith in protecting the public (integrity), are committed to fairness and justice (equity), and are responsive to emerging healthcare trends (agility). The mission and vision identify why the agency exists today, has existed for the past 105 years, and will allow its existence in the years to come.
Developing a strategic plan will provide a way of focusing and prioritizing objectives as the agency moves forward in the coming years. Mandated by law, the agency’s purpose is to protect the public. Therefore, the goal will remain the same in the next five or ten years, barring any legislative action from changing the law. Strategic planning to provide a roadmap of where the agency will be in the next thirty years should include workforce initiatives, regulatory solutions to address borderless healthcare delivery, development of agile regulatory systems for responsiveness to change, and pioneering competency assessments to support the future of health care. Additionally, the strategic plan should involve risk-based regulatory approaches and evidence-based practices.
It is essential to enhance public protection through collaborative leadership. One of the ways to achieve this is to increase the visibility and impact of the organization, promote legislative change, and ensure efficient and effective regulatory processes. Efforts should be made to ensure that current and evolving roles and responsibilities of nursing align with regulation. The writer envisions the agency as a catalyst for delivering innovations in education and practice and advancing best practices in nursing regulation. Finally, the cultivation of an organization that supports diversity, equity, and inclusion. The agency will strengthen collaborative relationships by fostering those opportunities that advance diversity, equity, and inclusion.
Hypothetically, the process described above can also be applied to a hospital situation by leaders in the C-suite. The essentials that impact hospital efficiency alluded to in the earlier discussion are to be considered by hospital leadership. Again, these essentials include organizational vision and cultural alignment, quality care as a cost-effective strategy, advanced analytics in the human capital equation, and the leveraging of technology. Waxman (2018) described that there must exist alignment between the chief executive officer, the chief financial officer, and the chief nursing officer (Waxman, 2018). Therefore, there must be a comprehension of the core business and the ability to process that essence into a unique strategic value position upon which decision making is based. Partnering with the C-suite leaders is necessary to define evidence-based clinical quality initiatives, which Waxman emphasizes is the exclusive responsibility of the nurse executive. The first step needed to gain operational efficiencies in a hospital setting is to gain clarity and alignment, which will eliminate wasted hospital resources.
It is essential for the nurse leader to focus on controlling expenses associated with different treatment methods and institutional operations without compromising the quality of care. The nurse executive must make intelligent decisions about how to invest resources. Creating a culture of continuous improvement to deliver sustainable quality healthcare in the hospital environment is essential.
Process improvement techniques using the five whys is an improvement tool that focuses on a step-by-step approach to uncover the root cause of a problem (SOMC, 2022). The steps include defining the problem, asking why, repeating the process of asking why until you have arrived at a root cause for the concern that is actionable, and creating an actionable and measurable plan. Utilizing this process in hospital and business settings is most appropriate when problems involve human factors or interactions. The process can also be used in implementing or changing policy. Inclusion of patient and staff experiences, patient safety, and clinical effectiveness are quality indicators that hospitals can implement to create such a culture.
References
SOMC. (2022, April). Process improvement: why, why, why, why, why (5 whys). Retrieved from https://www.somc.org/leadership/process-improvement-why-why-why-why-why
Waxman, K. (2018). Financial and business management for the doctor of nursing practice. New York: Springer Publishing Company.
Reply #1: RH
Nurses are required to demonstrate adherence to work ethics and values by applying professional nursing principles when making practice-related decisions. Integrity is an important professional nursing principle that defines the framework for professional nursing practice (Poreddi et al., 2021). Valuing integrity and applying it during decision-making proves that you embrace professional values that govern nursing practice. The value of integrity helps nurses to create a strong foundation for building meaningful therapeutic relationships with patients. It works together with moral integrity to reveal the humanistic nature that the nurse needs to display to enhance the achievement of positive therapeutic outcomes with patients (Poreddi et al., 2021).
The nurse, as a moral agent, relies on the professional values of integrity and accountability to provide quality and safe care that will improve patient outcomes. Nurses who demonstrate these two values are confident in their practice and maintain consistency in care that is informed by evidence-based practice (Poreddi et al., 2021). Although nurses engage in the delivery of direct care to patients, it is highly imperative that they perceive other professional values as important. The reason is that with such professional values, nurses can easily face and address the ethical issues that they commonly encounter in practice such as those faced during the COVID-19 pandemic (Dellasega & Kanaskie, 2021). Identifying professional values that guide your decisions is indeed a crucial step in defining the professional framework that guide your practice as a nurse.
References
Dellasega, C., & Kanaskie, M. L. (2021). Nursing ethics in an era of pandemic. Applied Nursing Research : ANR, 62, 151508. https://doi.org/10.1016/j.apnr.2021.151508
Poreddi, V., Narayanan, A., Thankachan, A., Joy, B., Awungshi, C., & Reddy, S. S. (2021). Professional and ethical values in nursing practice: An Indian Perspective. Investigacion y Educacion en Enfermeria, 39(2), e12. https://doi.org/10.17533/udea.iee.v39n2e12.
Reply #2: ND
It is possible for a small healthcare facility like your clinic to expand to become a large educational center for both patients and clinicians in the next 30 years. As a teaching hospital, the facility will be able to provide state-of-the-art clinical care to patients with complex medical conditions. Through its commitment to educational activities, the hospital will bring together aspects of patient care, clinical research, and medical education in an environment with advanced equipment and resources (Association of American Medical Colleges, 2022). According to the Association of American Medical Colleges (2022), teaching hospitals foster practice and educational environment that create opportunities for new discoveries and opportunities. In 30 years to come, your organization will employ the next generation of healthcare professionals with advanced training and expertise. I believe that doctorally-prepared nurses will play a key role in promoting leadership, research, and evidence-based practice in the hospital when it expands to a medical school in the next 30 years.
Due to the increased diversity of patients that they receive, large healthcare organizations usually deliver holistic patient-centered care that incorporates the cultural and religious beliefs of their clients. As you have anticipated, your facility should be able to deliver holistic care that integrates the religious and cultural lives of its clients (Regents of the University of Michigan, 2022). Once it grows to a bigger hospital, the clinic should benchmark with the C.S. Mott Children’s Hospital which has significantly improved health care through research and learning. Some of the advantages that the community will enjoy from the expanded hospital include improved healthcare quality, state-of-the-art technologies, and advanced treatment.
References
Association of American Medical Colleges. (2022). Sustaining teaching hospitals. https://www.aamc.org/news-insights/teaching-hospital-sustainability.
Regents of the University of Michigan. (2022). What is a teaching hospital? https://www.mottchildren.org/about-us/teaching-hospital.
Reply #3: PJ
Career transitions successfully occur when the incumbents engage in self-reflection in order to understand their strengths and weaknesses in relation to the roles that they are expected to perform when they assume new positions. To avoid feeling ineffective as they plan to assume leadership roles, doctorally-prepared nurses should identify and attempt to address gaps that might prevent them from performing as desired (Weston & Somers, 2021). Nurses who have received advanced training are adequately prepared to serve as C-suite executive leaders. It is true, as identified in your discussion, that C-suite executive leaders must understand the vision of their organizations to be able to offer proper direction (Waxman, 2018). As Weston and Somers (2021) explain, a nurse leader should position himself or herself in positions that offer a wide range of opportunities for applying their talents in a manner that will generate positive impacts for their organizations.
When assuming the role of a C-suite executive leader, today’s nurse leaders should strive to solve operational problems while also helping their states and the nation to fight inequity in health care. C-suite executive leaders are scientists and educators who perform other multiple roles that have an impact on the organization and the country where their organizations are located. These other roles include serving as educators and innovators within their settings (Azar, 2021). Generally, as nurse leaders, we should take actions that promote safety, quality, cos-effectiveness, equality, and equity for the benefit of patients, healthcare professionals, the organization, and the community.
References
Azar K. (2021). The evolving role of nurse leadership in the fight for health equity. Nurse Leader, 19(6), 571–575. https://doi.org/10.1016/j.mnl.2021.08.006
Waxman, K. (2018). Financial and business management for the doctor of nursing practice. New York: Springer Publishing Company.
Weston, M. J., & Somers, S. (2021). Transitioning to nurse leadership roles in nontraditional settings. Nurse Leader, 19(5), 456–460. https://doi.org/10.1016/j.mnl.2021.03.013