NURS FPX 8010 Assessment 4 Quality Improvement Proposal
Student Name Capella University NURS-FPX 8010 ExecutiveLeadership in Contemporary Nursing Prof. Name Date Quality Improvement Proposal “A successful nursing strategic plan establishes a roadmap for the future. It gives nurses a direction to follow and can refresh and reenergize an organization. A robust strategic plan is a critical component to ensure excellent patient care and the best possible outcomes” (Lal, 2020). To provide high-quality, cost-effective care, the creation of a department-specific strategic plan and balanced scorecard has been developed (see Figure A1). A growing source of frustration for patients and providers alike is inbox management. The ability to communicate with healthcare providers through email-like systems has become more prominent in the last decade. The NextGen Electronic Health Record (EHR), used at Adelante, like its many competitors, is not a perfect system, and yet more and more patients prefer and even expect timely messaging and results to and from their health practitioner. But when that system is flawed, it can create larger issues. At Adelante, the organization saw a 12% increase in provider attrition which mostly resulted from poor inbox management and/or a lack of a plan to support the large workload. Looking beyond the providers, patients are experiencing delayed care, diagnoses, referrals, and communication, which is ultimately damaging Adelante’s brand and reputation because of its direct impact on the patient experience. With the organizational demands to increase patient visits, enhance the quality of the visits, support digital infrastructure, and the decrease in available provider administrative time, the inbox management problem continues to grow. Patient messages are getting lost in the shuffle, and clinical staff don’t have the time to sort through the large volume of daily tasks. To put it simply, staff are overwhelmed, and patients are suffering. NURS FPX 8010 Assessment 4 Quality Improvement Proposal A key performance indicator (KPI) measure within the patient domain on Adelante’s balanced scorecard is patient satisfaction. Aligning with this indicator, the nursing department has chosen to elevate nursing practices aimed at patient-centric models of care and focus on the patient experience as it has direct ties at Adelante. For the purpose of this quality improvement project, the provider inbox issue will be addressed, and the patient experience will be improved. Success will be measured through patient satisfaction surveys yielding an 84% or greater likelihood to recommend rating. To achieve this, new policies will be developed and instituted along with daily clinical huddles to facilitate enhanced team communications (see Figure A2). Key Stakeholders and Policy Recommendations To solve this issue, in-depth analysis, collaboration, and provider buy-in will be required. Globally, many stakeholders exist, including patients, providers, and informatics teams. Arguably, “Patients are the single most important stakeholder group with regard to the learning healthcare system. They are both the donors of personal clinical data and the ultimate beneficiaries from the knowledge gained” (Eichler, Bloechl-Daum, Broich et al., 2018). More specifically, however, three departmental sponsors are called out in support of this proposal. N.G. works in the Clinical Informatics department. N.G. will be instrumental in the data collection, analysis, and dissemination portion of this project. In addition, she can help build technical specifications to support optimization of the provider inboxes. A.F. is the Quality Director and has a strong background in quality and manages a team that will help keep the project on track and within the regulatory confines of the organization. NURS FPX 8010 Assessment 4 Quality Improvement Proposal Also, considering this project is designed to impact providers and patients, A.F.’s involvement will keep the patient experience top of mind. S.A.L is the Regional Medical Director (RMD) for advanced practice providers and is responsible for providing leadership and direct oversight to APPs. She is a prior doctoral student and understands the intricacies involved in this project. S.A.L. has been invited into this project to keep the provider stakeholder perspective top of mind alongside the patient experience perspective. The two executive sponsors include the chief executive officer (CEO), P.C. and chief medical officer (CMO), R.B. at Adelante Healthcare. The CMO is responsible for providing organizational direction to licensed medical providers and their leaders to drive safe and effective medical services. As a licensed provider, the CMO also works with business administration functions and supports clinical implementation and innovation for the organization (Norris et al., 2017). Lastly, the CMO sponsorship is crucial in helping garner physician buy-in. The CEO is the key person responsible for the overall productivity and operation of the company. The CEO is instrumental in providing fiscal, political, and networking support. NURS FPX 8010 Assessment 4 Quality Improvement Proposal In assessing policy recommendations, it is noted that no current policies exist detailing inbox management or expected response times for patients. The largest recommendation would be to develop and institute a policy which clearly delineates when messages or tasks are received who manages them and in what time frame are patients having their needs addressed. For example, within 30 days of implementation, all patient messages will be addressed and receive a response within 48 business hours for routine, non-urgent needs. Development and implementation of this type of policy level sets expectations across the organization and extends to the patients so they know what to expect as well. Additionally, if implemented, this policy would allow clinical leaders to hold their teams accountable for their respective productivity and responsiveness that directly contribute to the patient experience. “Good communication skills are indispensable to basic concepts of nursing care as communicating effectively can help reduce the risk of medical errors, ensure better patient outcomes, and nurture patient satisfaction. A good patient experience– while considered merely desirable in the past – is moving center-stage” (Lang, 2012). The success of this project, if implemented would be determined by patient satisfaction numbers, which would demonstrate timelier patient-provider communications, and improved patient experiences. Continued success will also promote Adelante’s reputation in the community which may also drive more revenue through increased patient referrals. SWOT Analysis and Contemporary Change Theory In assessing the political landscape at Adelante Healthcare, traditional power dynamics exist
NURS FPX 8010 Assessment 3 Strategic Plan Development
Student Name Capella University NURS-FPX 8010 ExecutiveLeadership in Contemporary Nursing Prof. Name Date Strategic Plan Development The inclusion of the nursing department at Adelante Healthcare is a recent development, reflecting the rising demand for nursing services. This department is poised for expansion and operational restructuring. To ensure the delivery of high-quality and cost-effective care, a department-specific strategic plan and balanced scorecard have been formulated (see Figure A1). According to Lal (2020), a robust nursing strategic plan serves as a roadmap for the future, providing direction and revitalizing the organization. Adelante’s strategic plan encompasses four primary domains: finance, wellness, people, and patients. In the finance domain, the nursing department’s strategic priority aligns with the organization’s goal to increase revenue. Accordingly, the focus is on developing and implementing programs, such as the transition of care, to support indirect revenue generation. In the wellness category, Adelante emphasizes wellness outcomes and quality metrics. The nursing department prioritizes optimizing evidence-based practices to positively impact patient throughput across the care delivery model. Patient satisfaction is a key performance indicator (KPI) within the patient domain on Adelante’s balanced scorecard. To align with this, the nursing department aims to enhance nursing practices, emphasizing patient-centric models of care delivery and staff engagement. In the people domain, employee retention is crucial for Adelante. The nursing department strategically aligns with this by prioritizing structural empowerment and growing nursing professional practice through professional governance and shared leadership. Additional details on KPIs for the nursing department’s strategic plan are provided in Figure A2. NURS FPX 8010 Assessment 3 Strategic Plan Development These priorities hold significance as they span across all domains of the strategic plan, impacting various areas. The focus on professional practice enhancement and evidence-based care reaches both the patient and nursing populations, elevating practice standards throughout the organization. Prioritizing patient-centric care model delivery and throughput promotes interdepartmental collaboration and involves patients in improving their experiences. Additionally, the development and implementation of indirect revenue-generating programs have implications for the finance domain, indirectly influencing patient safety, quality, satisfaction, staff engagement, and empowerment, ultimately contributing to a strong organizational reputation within communities. While these priorities are expected to be achieved over the next 6 months, pending budget approval poses a current obstacle. The nursing department may face limitations in staffing and may need creative solutions based on the approved budget. Gaining buy-in from stakeholders across Adelante’s nine locations is another challenge, but enlisting support from executive sponsors and regional medical directors could facilitate smoother implementation. Effects of Organizational Policies The balanced scorecard serves as a common language and framework, ensuring alignment of goals and highlighting collaboration opportunities between departments (Wanga, 2022). Regular policy review and revisions are crucial to align strategic plans and balanced scorecards with organizational policies. At Adelante, recent policy reviews indicate no current policy-based challenges. However, as a newer department, growing pains may arise, necessitating ongoing policy reviews and adjustments to address unforeseen challenges. Conclusion Strategic planning and the implementation of balanced scorecards are essential tools for aligning organizational initiatives and departmental projects. Adelante Healthcare’s nursing department has developed a specific strategic plan and balanced scorecard aligned with the organizational strategy plan. While the outlined priorities are expected to be achieved over the next 6 months, the department acknowledges potential growing pains and unseen challenges. Regular policy reviews are recommended to ensure alignment and address any emerging challenges. Ultimately, the application of the nursing department’s strategic plan and balanced scorecard aims to achieve equilibrium across disciplines and optimize Adelante’s organizational growth (Stefanovska & Soklevsk, 2014). References Dilrajh, A. (2020, May 22). A few advantages of implementing the BSC in your organization. Vision Activ. Retrieved October 12, 2022, from https://www.visionactiv.com/post/a-fewadvantages-of-implementing-the-bsc-in-your-organisation Lal, M. Maureen DNP, MSN, RN. (2020). Why You Need a Nursing Strategic Plan. JONA: The Journal of Nursing Administration, 50(4), 183-184. doi: 10.1097/NNA.0000000000000863 Miller, K. (2020, February 25). A manager’s guide to successful strategy implementation: HBS online. Business Insights Blog. Retrieved October 12, 2022, from https://online.hbs.edu/blog/post/strategy-implementation-for-managers Stefanovska, L., & Soklevsk, T. (2014). Horizon Research Publishing | Home. Retrieved October 12, 2022, from https://www.hrpub.org/ Taylor, A. (2019, July 23). How to generate buy-In for your strategic plan. Strategic Planning Consultant. Retrieved October 11, 2022, from https://www.smestrategy.net/blog/5-stepsto-increase-buy-in-with-your-strategic-plan Wanga, E. O. (2022, September 12). The Balanced Scorecard in healthcare: Everything you need to know. Experience Care: Long-Term Care EHR & Financial Software Solutions. Retrieved October 11, 2022, from https://experience.care/blog/the-balanced-scorecard-inhealthcare/ NURS FPX 8010 Assessment 3 Strategic Plan Development
NURS FPX 8010 Assessment 2 Strategic Plan Appraisal
Student Name Capella University NURS-FPX 8010 ExecutiveLeadership in Contemporary Nursing Prof. Name Date Strategic Plan Appraisal A strategic plan within healthcare functions as a guiding framework for organizations to envisage and plan for the future (Fry & Baum, 2016). This paper provides a critical analysis of the strategic plan implemented by the Department of Veterans Affairs (VA), which oversees the largest integrated healthcare network in the United States, serving over 9 million Veterans annually (Department of Veterans Affairs, 2022). Strategic Plan Analysis The mission of the VA is to honor and serve American Veterans, guided by core values such as Integrity, Commitment, Advocacy, Respect, and Excellence (U.S. Department of Veterans Affairs, 2021b). The 2022-28 Strategic Plan delineates four goals, 13 objectives, and 75 strategies to fulfill the mission (Department of Veterans Affairs, 2022). Key priorities, encompassing trust, communication, and accountability, are intricately woven into the mission and core values. These priorities form the bedrock for maintaining relationships, transparency, and commitment to serving Veterans. Validity of Data and Analytical Strategies The VA employs a meticulous analytical approach, incorporating gap analysis and workshops to identify current and desired states (Department of Veterans Affairs, 2022). The strategic plan accentuates the utilization of customer experience data, population-level statistics, and analytics to inform decision-making. Strategic Goal 4 underscores the commitment to managing data as a strategic asset, with Objective 4.2 specifically highlighting the role of the Office of Data Governance and Analysis. Stakeholder Input Stakeholder consultation, involving senior leaders, Federal agencies, Veteran Service Officers, members of Congress, employees, Veterans, and caregivers/families, plays a pivotal role in shaping the VA’s strategic plan (Department of Veterans Affairs, 2022). The feedback from stakeholders is integral to driving change and achieving Strategic Goal 3, which focuses on creating a culture of accountability driven by ethical behavior and trust. Balanced Scorecard The VA employs a Balanced Scorecard (BSC) as part of its strategic planning process, addressing financial, customer, internal business process, and learning and growth perspectives (Kaplan, 2020). Financial initiatives include the implementation of the Financial Management Business Transformation program. Customer-centric efforts aim to enhance the Veteran experience and provide multilingual communications. Internal business process improvements involve digital modernization and harmonized online experiences. Learning and growth initiatives focus on continuous development, as evident in leadership training programs. Conclusion Strategic planning is imperative for healthcare organizations to establish a path for achieving critical goals and ensuring a unified direction (Association of American Medical Colleges, 2022). The VA’s strategic plan underscores its commitment to mission-focused outcomes, customer satisfaction, and fostering a culture of trust, safety, accountability, and transparency. References Association of American Medical Colleges. (2022). Strategic planning. https://www.aamc.org/professional-development/affinity-groups/gip/strategic-planning Department of Veterans Affairs. (2022). Fiscal years 2022-28 strategic plan. http://www.va.gov/oei/docs/va-strategic-plan-2022-2028.pdf Fry, A., & Baum, N. (2016). A roadmap for strategic planning in the healthcare practice. The Journal of Medical Practice Management, 32(2), 146–149. https://www.proquest.com/docview/1836565558?accountid=27965 Kaplan, R. S. (2020). Using the balanced scorecard for successful health care M&A integration. NEJM Catalyst, 1–8. https://doi.org/10.1056/CAT.20.0286 U.S. Department of Veterans Affairs. (2021a, March 23). Data governance and analytics. https://www.va.gov/oei/about/data-governance-analytics.asp U.S. Department of Veterans Affairs. (2021b, March 26). About VA: Mission, vision, core values & goals. https://www.va.gov/about_va/mission.asp NURS FPX 8010 Assessment 2 Strategic Plan Appraisal
NURS FPX 8010 Assessment 1 Political Landscape Analysis
Student Name Capella University NURS-FPX 8010 ExecutiveLeadership in Contemporary Nursing Prof. Name Date Formal and Informal Lines of Power in Healthcare Organizations In healthcare organizations, a range of power lines exists, comprising both formal and informal dimensions. The formal lines of power are clearly delineated within the organizational hierarchy, including roles such as the President, Head Nursing Official, and CFO. These roles are explicitly defined in the organizational chart, providing clarity on responsibilities. Conversely, informal lines of power are cultivated through relationships and trust-building. For instance, the Head Nursing Official wields both formal power, defined by their position, and informal power, derived from connections and communications with others. As a new leader in my organization, I currently possess formal power, but the development of informal power is an ongoing process. Building relationships and trust with colleagues and the organization is essential for the establishment of informal power. A balance between formal and informal power is crucial for effective leadership. Collaboration with the team, adherence to organizational policies, and openness to others’ input contribute to a positive impact within the organization. Organizational Power Influences on Executive-Level Decision-Making Understanding the organizational structure is paramount for effective leadership. Continuous changes in healthcare policies require leaders to comprehend the rationale behind them for successful implementation. Seeking guidance from superiors and considering the impact of policies on all stakeholders aid in decision-making. Strategic agility, the ability to adapt to new approaches and innovate, is essential for navigating change effectively (Shirey, 2015). Leaders must possess a keen awareness to detect opportunities and decisively act on them. In the ever-changing landscape of healthcare, leaders must foster a positive and communicative environment to achieve success. Power dynamics are contingent on individual perspectives, emphasizing the need for leaders to adopt new strategies to address the evolving needs of providers and colleagues. The Impact of Power on Organizational Policy The current clinical director in my organization demonstrates a robust combination of formal and informal power. To contribute to transformative initiatives, I aim to introduce diverse perspectives, emphasizing inclusivity and cultural awareness. Acknowledging the political aspects within the organization, I plan to leverage my informal power to facilitate collaboration and address challenges related to patient burden and workload. Engaging with colleagues and utilizing their input fosters a cooperative atmosphere, contributing to successful policy changes. By employing both formal and informal power, leaders can navigate organizational politics and achieve positive outcomes. The goal remains focused on patient-centered care, ensuring that organizational policies align with the diverse needs of the workforce. Conclusion Building on formal and informal lines of power is a continuous process that demands collaboration and compromise. Experience in the workplace shapes these power dynamics, with organizational charts providing a foundation for understanding roles and responsibilities. The integration of formal and informal power, exemplified by successful leaders, enhances the ability to implement new initiatives. The journey toward becoming a respected leader involves managing challenges, demonstrating effective leadership, and ultimately contributing to positive outcomes within the organization. References Shirey, M. R. (2015). Strategic Agility for Nursing Leadership. JONA: The Journal of Nursing Administration, 45(6), 305-308. doi: 10.1097/NNA.0000000000000204. Waring, J., Bishop, S., Clarke, J., Exworthy, M., Fulop, N. J., Ramsay, A. I. G., & Hartley, J. (2018). Healthcare leadership with political astuteness (HeLPA): a qualitative study of how service leaders understand and mediate the informal “power and politics” of major health system change. BMC Health Services Research, 18(1), N.PAG. https://doi.org/10.1186/s12913-018-3728-z NURS FPX 8010 Assessment 1 Political Landscape Analysis