The tool called HCAHPS Survey Instrument is helpful in getting idea about the patient’s satisfactions in service delivery (Jadotte et al., 2017). With the use of the HCAHPS Survey Instrument, it was noted that the patients was quite dissatisfied with the quality of care provided by the nurses. As it was a survey, it was not possible to develop a broad idea about the feelings of the patients but it seemed inevitable form the interviews that the patients seemed themselves vulnerable and developed a feeling of disempowerment. They felt that the nurses did not respect the autonomy as well as the dignity of the patients and often tried to impress their own interventions on them. They did not like to participate in any discussions with the patients which made them vulnerable. These made them upset and as a result they were getting depressed or agitated. There is indeed evidences which suggest that the way nurses provide care to patients are important in helping patients to recover the disorders. The quality of nursing care provided in healthcare settings are often researched by different researchers and they have come to the view that person centered care is helpful in making patient’s condition stable and develop a therapeutic relationship with them (Melnyk et al., 2014). The patients in my appointed hospitals was never given a chance to participate in decision making and were not properly educated them with the intervention they were applying. A similar chapter was selected where more or less a similar scenario was suggested where the patients complained of lack of readiness and preparedness of the nurses when they visited them. Lack of shared decision making activities were noted by them. They also complained of delayed nurse’s responses as they have noticed nurse shortages as a reason . The researchers of one primary article suggested misalignments in systems, care processes and also improper nurses’ response affected the quality of care by making patients disempowered and increased their sense of vulnerability. The post intervention phase where they used inculcation of various strategies to develop person centered care was indeed found to be fruitful (Storm et al., 2014). Patients suggested that the nurses became more compassionate and empathetic and considered every one as family members. The nurses develop proper ways of engaging themselves with patients and developed a relationship which helped them to maintain the patient’s autonomy and dignity (Yost et al., 2015). Thereby by following the above mentioned researches, the main intervention that I would apply is to introduce training sessions for the nurses to provide them how to adapt strategies of inculcating person centered approaches. Moreover the issue of nurse shortages would be to handle to the HR department so that work pressure and burnout do not hamper the quality of care provided to patients.
Another process to review the quality of service provided to patients is to use audits and feedback interventions. In spite of carrying on regular audits and feedbacks in my organisation, results have been found to be null and therefore the result were becoming futile even after proper audits and feedbacks were conducted. This forced the healthcare center to get confused as they were not finding the right tool for judging the quality. This scenario of my organisation can be explained with the work of Ivers et al in the year 2014. According to this researcher and his team, the ‘business as usual’ mode of audit and feedback never bas become successful in one quarter of their tested healthcare centers but have again failed miserably in another quarter of their tested healthcare centers as they have provided null effect on the development of quality of services (Gould et al., 2014). They have suggested that understanding their mechanism of actions and identifying the key active ingredients is extremely important to make the intervention successful. Often following the business as usual approach that evaluates two arm trials of audit and feedback interventions against usual care for common issues and different settings do not bring out proper results. They fail to help in providing new generalizable settings. They continue to keep themselves restricted only to the known areas of healthcare practice and do not allow testing the effectivity of any new idea that could be introduced for betterment (Zorio et al., 2013). Researchers here therefore have come to conclusions that the audit and feedback sessions of the future should incorporate evidence as well as theory based practices and they should be so arranged that they will address the known gaps in the literatures (Ivers et al., 2014). All the audit components, feedback components, nature of the behaviour change required and target goals and action plans should be fixed before the audit is carried out. They have proposed a tentative audit plan which if implemented in the audit and feedback pieces will bring out change in quality of the service. Hence, I would also try to follow the paper closely and by the guidance of the researchers will alter the audit and feedback.
Another important issue that has been marked by me in the healthcare center that often hampers the quality of the service provided is the inappropriate communication of the team members. It has been already proposed before to the professionals that they need to work in a team in order to provide a quality care to the patients. However, though teams are allocated with proper ration of each type of healthcare professionals, they do not bring out the best effects. It has been noted that often medical specialists experience a power over the other professionals and do not properly cooperate with everyone and hence different complexes are seen to arise among different individuals who ultimately fail them to participate in effective teamwork. A similar such issue was depicted by Hartgerink et al., in the year 2013. His study has shown that although nurses try to communicate with all professionals and try to implement interventions after discussing with every team members, medical specialists do not pay importance to other’s work and tend to change their intervention without discussing with anyone. This often leads to confused state of treatment and the patients are mostly the victims for it (Ajeigbe et al., 2013). In order to reduce the tensions among the team members and to develop the communication and relational coordination among the healthcare professionals, it is very important to make every team members meet in the multi-disciplinary team meetings and participate in team climate development procedures (Hartgernick et al., 2014). The researchers have clearly concluded that the success of this quality improvement technique will not only depend on the frequency of team meetings but also the number of the professionals represented that has a positive influence. The coordinated response for the different types of activities as well as different information which result from relational coordination is mainly believed to be significant in for effective and efficient care delivery (Sacks et al., 2015). Therefore form this paper I have learnt that I will also try to implement the interventions of conducting weekly multidisciplinary team meetings and development of team climate to make the quality of care better for the patients and to raise the reputation of the hospitals.
References:
Ajeigbe, D. O., McNeese-Smith, D., Leach, L. S., & Phillips, L. R. (2013). Nurse-physician teamwork in the emergency department: impact on perceptions of job environment, autonomy, and control over practice. Journal of Nursing Administration, 43(3), 142-148.
Gould, N. J., Lorencatto, F., Stanworth, S. J., Michie, S., Prior, M. E., Glidewell, L., … & Francis, J. J. (2014). Application of theory to enhance audit and feedback interventions to increase the uptake of evidence-based transfusion practice: an intervention development protocol. Implementation Science, 9(1), 92.
Hartgerink, J. M., Cramm, J. M., Bakker, T. J. E. M., Eijsden, A. M., Mackenbach, J. P., & Nieboer, A. P. (2014). The importance of multidisciplinary teamwork and team climate for relational coordination among teams delivering care to older patients. Journal of Advanced Nursing, 70(4), 791-799.
Ivers, N. M., Sales, A., Colquhoun, H., Michie, S., Foy, R., Francis, J. J., & Grimshaw, J. M. (2014). No more ‘business as usual’with audit and feedback interventions: towards an agenda for a reinvigorated intervention. Implementation Science, 9(1), 14.
Jadotte, Y. T., Chase, S. M., Qureshi, R. I., Holly, C., & Salmond, S. (2017). The HCAHPS Survey as a Potential Tool for Measuring Organizational Interprofessional Competency at American Hospitals Nationwide: A Content Analysis Study of Concept Validity. Health and Interprofessional Practice, 3(2), 1.
Melnyk, B. M., Gallagher?Ford, L., Long, L. E., & Fineout?Overholt, E. (2014). The establishment of evidence?based practice competencies for practicing registered nurses and advanced practice nurses in real?world clinical settings: proficiencies to improve healthcare quality, reliability, patient outcomes, and costs. Worldviews on Evidence?Based Nursing, 11(1), 5-15.
Sacks, G. D., Shannon, E. M., Dawes, A. J., Rollo, J. C., Nguyen, D. K., Russell, M. M., … & Maggard-Gibbons, M. A. (2015). Teamwork, communication and safety climate: a systematic review of interventions to improve surgical culture. BMJ Qual Saf, 24(7), 458-467.
Storm, M., Siemsen, I. M., Laugaland, K., Dyrstad, D., & Aase, K. (2014). Quality in transitional care of the elderly: Key challenges and relevant improvement measures. International journal of integrated care, 14(2).
Yost, J., Ganann, R., Thompson, D., Aloweni, F., Newman, K., Hazzan, A., … & Ciliska, D. (2015). The effectiveness of knowledge translation interventions for promoting evidence-informed decision-making among nurses in tertiary care: a systematic review and meta-analysis. Implementation Science, 10(1), 98.
Zorio, A., García?Benau, M. A., & Sierra, L. (2013). Sustainability development and the quality of assurance reports: empirical evidence. Business strategy and the environment, 22(7), 484-500
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