Healthcare management is an essential aspect that helps in maintaining the healthcare sector effectively in a way where a smooth functioning of services is provided to the patients with proper quality. A large number of internal issues may obstruct the smooth flow and hence it the duty of the healthcare managers to assess situations and provide strategies accordingly (Betancourt et al. 2016).
I have been placed as an intern in a renowned hospital as a developmental manager where I had gather many experiences and also identified a number of issues and provided strategies for them effectively.
1.Gibbs reflective model is the best tool which is required by an individual to effectively reflect the differsetn experiences he had and thereby help him to decide what are the initiatives atht he would take to solve the issue.
The first aspects of the Gibb’s reflective cycle usually describe the situations that had taken place and what were the feelings of the individuals at that time. It then helps him to evaluate the situation and analyze the situation. Herein, I have used these four steps to describe and analyze the situations that had been recognized by me. The first issue that I noticed in the organization was the rise of miscommunication among different nurses that often hampered the quality of healthcare provided by them to the patient. It also affected their working procedure and hampered the entire plan of intervention that each of them followed for the patients. The most severe issue that was noticed was the medication errors that were done by the nurses which often resulted in long stays of patients in the hospital and increased the risk to adverse outcomes. When the factors contributing to medication errors were evaluated, it was surprising to see that less knowledge, skill and experiences were the main reasons of the medication error. The main factor behind medication error was that due to ineffective communication among the nurses, delegations and handover of patients were not properly discussed and documented (Free et al. 2014). As a result, often medication errors took place where the nurse of the next shift either took administered the medication in wrong dose or by wrong route or applied an intervention which was not planned by the previous nurse of the shift. These situations mainly occurred as there were not aware of the different communication procedures that they should have incorporated within themselves helping them in effective teamwork (McPherson and Pincus 2016). Another occurrence that I used to notice on a daily basis in the healthcare sector was that of long waiting times. Out of the complaints that had been lodged into the outdoor patient complaint box, 40% of them contained complaints of long waiting times. The other steps of the Gibb’s cycle mainly involve drawing conclusion of the situation and preparing an action plan to overcome the problem. I conducted a thorough investigation for the entire factors that resulted in long waiting times. It came to my knowledge that inappropriate communication among the nurses providing the appointments on call, physicians who would be attending the patients and also the nurses helping the physicians were poor. This resulted in providing time slots to the patient which was overlapping, when the doctor had yet not arrived or when no nurses are present to attend the doctor (Blais 2015). Besides, disagreements and differences in opinion among the different nurses have been seen to escalate to serious conflicts. This mainly rises when the nurses try to avoid effective communication mainly due to their complexes and ego or just due to causality thinking that it might just go away. Weaver et al. (2016) has stated that these kinds of conflicts severely affect their mental stability and emotionally and as result the care provided to patients get compromised . Often poor decision making is also seen among the nurses of the organization. Poor decision making may be due to lack of communication of the enrolled nurses with the registered nurses or the lack of ability to help their juniors by the registered nurses through appropriate communication skills. The junior nurses were found to be clueless when they needed help or guidance but was not comfortable in communicating with their issues. This also affected the quality of care that the nurses provided to the patient resulting in poor health (Zingg et al. 2015). Moreover lack of communication also results in increased stress among the nurses as they were not able to communicate the issues that they were facing, they were getting stressed up (Langabeer and Helton 2015). Communication also creates bonds among the nurses. As bonds were not present, I witnessed that the nurses faced mental stress as they were not emotionally connecting with their colleagues and therefore their work pressure were not properly distributed. Therefore after witnessing such issues I initiated a number of workshops which encouraged nurses to develop communication skills. I also divided the nurses’ in team so that they learn working in collaboration which in turn is believed to influence relationship building and hence effective communication. Moreover, effective feedback distribution meetings were also arranged by me where the nurses exchanged both their negative and positive impacts of their colleagues so that a more transparent environment is created and bonding develops better (Vashisth, Schneider and Luong 2014).
The first few steps of the Gibb’s cycle helps in describing the situation that had taken place and what the individual was feeling at that time. It helps the individual then to evaluate the entire condition and analyze the situations. Another important negative aspect that I witnessed in the hospitals is the lack of proper flexibility of work. Nurses were often found to complain of stresses which they were suffering due to excessive work pressure. Moreover, they were also not being able to take planned leave due to shortage of nurses and due to high amount of responsibility of patients allocated for each one of them. Researchers like Buchbinder and Shanks (2016) have conducted experiments where they have stated that organizations which provide highly flexible work lives enjoy their practices more and tend to be more contributing to their work thereby increasing flexibility. In these hospitals, due to shortage in nursing often nurses are forced to do overtime which are often resulting them to get overstressed. It is found by different researchers that nurses who are able to maintain a proper work life balance can not only be satisfied with their job experiencing higher job satisfaction but also feels relaxed with their profession and their practices (Zhou et al. 2015). This has a very positive impact on the life as well as the care provided to the patient. A nurse who experiences proper work life balance is also found to enjoy proper mental health as well as physical well being that in turn raises their capability to tackle many crucial situations at the hospital effectively (Powers et al. 2015). Moreover, I also found that allocation system of the nurses was not conducted in the proper manner and partiality was done for a group of nurses by the nursing manager which affected the confidence of other groups. The other parts of Gibb’s cycle included conclusion and drawing of an action plan that needed to be taken in such situations. I realized that there is an important need to renew the structure of the work-flexibility advantages so that the nurses can get access to systems where they will be able to manage a proper work life balance. In order to assure that the nurses enjoy proper job satisfaction, I planned the entire system and introduced the concept of a number of new approaches. These consisted of the concept of float pools. Abdelhak, Grostik and Hanken (2014) have stated that this usually act as resource pools which will help the hospital in providing efficient nurses when the registered nurses or enrolled nurses are not present on duties or had taken leaves for personal issues or due to ailments. These would help the nurses on leave to recover themselves from their ailments and also to met any emergency situation in life and thereby enjoy a proper family life balance. At the same time it will also ensure that the services provided to the patients remain unhindered (Aiken et al. 2014). Besides job sharing was another initiative where nurses were allowed to decide among themselves and switch their shifts in way which will not affect the service provided to the patient but will ensure that the nurses are satisfied to perform their personal duties with the switching of the shifts as per their requirement. Moreover per-Diem nursing facility was also introduced which assured that nurses are also available on on-call basis that will help filling up the gaps at the same time will save the fund of the hospital that would have required for recruiting a full time nurse for few days due to another nurses’ leave (Cherry and Jacob 2014). This assured less burning out, proper work life balance, job satisfaction and proper mental and physical well being.
2.The term CPD stands as continuing professional development. By the term, one means the entire process of tracking as well as the documenting of different skills along with the knowledge and experience that an individual can accumulate both in formal settings and in informal setting when the individual works in addition to the training that he has already gathered (Castiglione et al. 2015). This term mainly helps in referring to the entire sequential documentation that the individual had first experienced and then learnt and then applied in his field. In short, it is often referred by many organizations to be a portfolio or physical folder that mainly helps in making records of the developments that the individual made as a professional (Bates et al. 2014).
After completing my graduation in September this year, I was mainly focusing myself on my career and I was trying to develop my theoretical skills that I have developed in my course years. I participated in many workshops which helped me develop my management skill and I also applied for much internship before settling with a full time job. I applied my bio data to all the reputable organization and seeked for the position of managerial riles in the healthcare sector only. I uploaded my CV on the job portals in the nation which ensured my chances of getting better jobs. I prepared myself to attend the interview. I had to be confident enough with my skills as that the interviewer can see a promising leader in me. After much preparation, I was able to get the job in one of the esteemed hospital where I was provided the position of the developmental manager. They were very happy to see my achievements in my academic lives and the various workshops in had attended. The various internships which I participated were a plus point for my career as they were expecting to recruit someone with better job experiences. On the first day, I mainly had the induction where I was made to discuss my flexibilities and my responsibilities with the HR department. They informed that I had to undergo a training session for three months so that the senior manager can describe my role properly and at the same time evaluate my working skills. These trainings helped me to brush up my management skill and also get accustomed to the working environment of the organization.
The training gave the scope that an individual gets in order to develop his own skills which is required by him to excel in the field where he is currently working. (Olseske 2014). It helps in progressing from a basic knowledge to more advanced, mature as well as complex understanding. In short term, the entire episode helped me in sharpening the different ranges of skills like managing projects, leaderships as well as organizing information which was already learned previously (Ahn et al. 2013).
In the first 12 months of the entire program, it helped me in providing an overview of different professional development in the 12 months. The CPD guided me about how to handle the career and thereby helped me to keep an eye over the goal in order to ascertain whether the goals are achieved or not (Jordon et al. 2013). It helped me to uncover different forms of gaps that I realized in my skills and abilities and accordingly set my missions in that particular way. (Grol et al. 2013).
3.The organization had conducted a Manadatory Training program for all the managerial interns to brush up the theoretical skill and to discuss the various barriers that the interns were facing while they were trying to apply their thinking into the work.
The training program had divided the discussion session into four distinct areas which consisted the interpersonal skills, information management, analytical skills and also action skills. Division of the entire training session into distinctive four parts was the best part of the training. The first part is the interpersonal skills which helped in discussing the four important domains like the leadership skill, the relationship skills as well as discussed how to properly help and delegate colleagues and juniors. The second area helped us in learning about the domains like creativity inculcations in the regular experiences to bring out a best result. Besides, the third part contained information gathering and information analysis were also discussed and helped people in learning the important role that proper information can contribute to management (Friedberg et al. 2014). The fourth domain discussed in the training was the analytical skills that included proper planning, technology management as well as quantitative data analysis. The action skills mainly included the learning of the procedures which a healthcare manager would follow in order to ensure that he can bring the best effect to the organization (Groher et al. 2016). The training showed the trainees the correct ways of setting goals and thereby plans the action that needs to be taken to accomplish the task.
The training model covering the important domains was found to be extremely because it helped each and every manager starting from the relationship development manager to the service manager to business revenue manager to develop strategies so that they can overcome barriers in their perspective field. It not only helped in developing the interpersonal skill important for maintaining coordination and relationship with the coworkers but also helped in developing a working environment which helped everyone to work with satisfaction. Again management of important information by the different manager and analyzing them to develop strategies were also helpful from the ideas given in training (Brady et al. 2013). Both analytical and action skills are much important for the managers of all backgrounds so that they can critically analyze the situation and help in managing their teams and crucial situations to benefit the organizations and help in managing members effectively to make sure that the organization gets the best productivity.
It helped in simplifying the entire meeting and helped the interns by depicting the area where exactly they need to develop their skills.
It helped many of the interns specially learn how creating bonds ensure smooth flow of work and less tensions among coworkers (Gatchell et al. 2014). These training helped the people because it depicted the barriers faced in every fields of management and gave examples to make people understand how to handle adverse managerial conditions. The fourth part that the training helped in inculcating among the trainees is the action skills. The different steps were extremely important for the trainees to learn managerial skills and helped them to understand different techniques by which objectives can be achieved by the minimum allocation of the resources at the same time of completing the project within deadlines and routing the others and at the same time develop efficiency. The last domain it covered is the entrepreneurial skills which mainly helped us in developing the ability to take initiatives and at the same time adapt to new opportunities, face risks and challenges, making proper decisions in crucial uncertain conditions and also allow different things to happen.
4.An area manager mainly helps in working closely with a number of staffs and other managers like departmental manager, sales team and others with the main aim of maximizing sales and profitability. The individual need to work with the area manager to improve the condition of two important conditions which is not being managed properly and hence had resulted in severe downfall of quality of service provided to patients.
Along with the area manager, the individual realized an arena that was never addressed before. While closely analyzing the services provided by the nurses to patients, it was seen that the patient with culturally diverse backgrounds were not at all satisfied. They complained that the treatment which was provided to them was unethical as it disrespected many of the traditions as well as the cultures that they possessed (Armony et al. 2015). Different patients have different cultures and the service provided by the nurses should always respect that. The interventions required as well as the communication procedure by people from different background like Islam, Hispanic and many others often have different sets of customs and traditions. The use of alcohol in treatment of Islam is highly unrespectable and should never be used by the nurse to avoid any cultural issue. Moreover talking to many patients of different cultures with direct eye contact and similar others are considered. Hence all these issues should be carefully handled. A main issue that had been found is that the nurses have very limited knowledge about handling patients of different cultural background and have no idea to tackle the legal and ethical considerations. Therefore a proper training is required to train the nurses to provide services to such patients with proper knowledge about their cultures and preferences. These would assure patient satisfaction and would also ensure avoidance of any ethical and legal obligations. Proper workshops, guiding manuals of different cultures, internet websites, and evidence based studies and other resources should be provided to nurses. Besides, planned training classes of the nurses should be conducted to tan them how to handle such situations effectively (Bloom et al. 2015).
Another important issue that was noted by the individual was that a large number of nurses were burning out and hence these had a severe impact on the quality of healthcare provided to the nurse. Complaints are usually lodged by the service manager to the area manager and therefore it becomes his duty to research the main reason that had resulted in such consequences and provide strategies so that these effects get properly addressed (Bloom et al. 2015). Thorough researches have been conducted which showed that strenuous working shifts of the nurses had been the sole reason which had impacted them both physically and mentally. Physically it had made them to develop fatigue, sleeping disorders, backache and headache and many others. Mentally they have become depressed and is not being able to concentrate on their work as they believe that they do not have proper work life balance. This is hampering their personal life which is indirectly having their effects on professional life. Hence proper introduction of different strategies are proposed which would help in the management of burning out in nurses (Berkowitz 2016). Work flexibilities like week-offs according to nurses’ wishes, float pools providing nurses in when registered nurses take leaves, provision of part time work shifts, job sharing procedures, as well as alternative scheduling like changing shifts among nurse colleagues yet meeting the desired result are implemented. All these provided them scope to manage their physical and mental stresses and hence the problem was resolved.
5.There are different types of management styles that an individual may follow in his profession to experience the best outcome. They may be directive, authoritative, affiliative, participative, pacesetting as well as the coaching style. Different types of managements are followed by different manager depending upon their own wishes and determination in order to bring out the best from the employees. This is also done to ensure that the management style is such that it brings out the best productivity for the organization. This style is extremely suitable to be taken in a healthcare setting because it invites the suggestion of the employees to come forwards and pour their concern regarding the service of the healthcare. The acceptance of suggestion as well as feedback from the employing and then deciding on the initiatives to be introduces and the strategy to be adopted is the main principle of this type of management style. In healthcare facilities gathering information and feedback from the nurses is extremely important as the main service provided to the patient are in their hands and therefore it becomes often difficult for a manager to effectively understand the strategy or the initiatives that would lead to betterment as managers are not directly involved in service provision (Fitzgerald and Dufour 2013). As the doctors, nurses, caregivers, physiologists, psychiatrists, surgeons and many other members of the multidisciplinary team are directly involved in providing service and are in direct discussion with patients, their recognition of the issues are much stronger and hence their suggestions and feedbacks to the manager is found to be extremely important for the manager to provide the best strategies to overcome different issues.
Due to increased participation of the all the team members in decision making procedures, the members are well known of their responsibility and therefore they can now take charges actively. Working hours may often get extended due to their own without any force from their manager in order to complete their allocated tasks. Moreover, an increased levels of association between the team members increases productivity. Second positive impact is that it helps the team members to experience job satisfaction. When team members see that their suggestions and recommendations are considered and implemented in their practice, they feel that they are respected and in turn feels accepted in the organization. This makes them contribute more to the organization and hence organization sees success (Huber 2013). Other important positive aspect is that it helps the team to provide motivation as they know that their suggestions are cared for and this in turn leads the fourth positive aspect which is improved quality of the service that is provided to the patients. As the problems that the nurses face while treating different patients are discussed, therefore the recommendations are prepared accordingly and it rightly addresses the issues without creating any frustration within the multidisciplinary team.
The disadvantages that mainly include this type of management is that as it involves suggestions from huge number of team members and many take participate in decision making, the entire procedure of introduction of strategies slows down. Moreover, as information comes from different individuals of the team having different perspectives, it requires time for the verification of the accuracy of the facts that in turn slows down the procedure. Moreover there may be a chance of security concerns. These is because s a lot of information are known to different team members of the multidisciplinary team which may become crucial days later and at this time it might be threat from the information being leaked out (Miller and Tucker 2013).
6.When audit was conducted, a number of issues came into focus. The service provided to the patients by the nurses were efficient but could not be considered excellent. This is because the nurses were not properly communicating among them and were stressed out from their long shifts. Except it, their skills of critical analysis, their knowledge of different disorders, their handling of critical cases are extraordinarily efficient. Hence the action plan mainly included the arrangement of classes which will help them to overcome communication barriers. The action plan also included the introduction of new strategies that ensured different approaches for reduction of the nurse burnouts. Audit showed that there was rising number of complaints regarding long waiting times at the outdoor units. This was mainly due to improper communication between the different healthcare staffs and this was handled by arranging training classes from communication which also helped in assuring better communication between nurses and also resulted in service quality development for the inpatients as well. Proper workshops and resources were given to healthcare practitioners to overcome barriers in treatment of patients with diverse backgrounds. All these were affecting the sales figures because as the culturally diverse patients were not happy with the service, their word of mouth was affecting the sales figures. Therefore it was necessary to include strategies in action plan that would address this (Unutxer et al. 2013).
7.A quality review of the organization was made with the help of a number of quality indicators. The first part of the indicators is planning. The planning conducted by the higher authorities is mainly profit based and they provide less importance to the health of the employees which affect service quality. However the planning conducted by nurses before providing interventions are critically analyzed by them and therefore rates of errors are much less. Arnaboldi, Lpasey and Steccolini et al. (2015) have stated that communication procedure is made more efficient, service provision would be better. Records of staff meetings, when analyzed, showed suggestions which were given by staffs for the betterment of the hospital and the services provided to the patients. The records showed that each and every stakeholder is really concerned about the well being of the hospitals and also provided many suggestions that worked well for the service delivery. Close observations although picked out different issues in nurse’s practices like improper communication among colleagues, burning out symptoms, and improper treatment to culturally diverse patients and many others. All these showed that the service of the nurses was not up o the mark and there is urgency in service improvement. Appraisal meetings were analyzed and showed that all the stakeholders have provided important contributions assuring that proper service delivery is conducted. The manager often attended meeting and training sessions as it helped them in polishing their skills and helped them to provide innovative strategies for enhanced service delivery. Most of the care standards were properly maintained and healthcare workers were skilled enough to handle critical situations. They had proper analytical skill and treated patient with utmost care and affection. They lacked knowledge in treating culturally diverse patient and their communication skills were not appropriate. Other than these, there were no negative aspects that could have been marked on their behalf.
8.Oshima and Emanuel (2013) has stated that as a leader, a service improvement programmed should be proposed after thorough analysis of the different issues and the complaints obtained from different patients, staffs and other stakeholders. Moreover pressure from the employer to increase productivity was also another reason for the implementation of the service improvement plan. First of all the burning issues were identified and different work flexibilities were introduced to make the nurses accommodate according to their advantages at the same time if not affecting the service provided to patients. The result was evaluated through feedbacks from the nurses and also from their attendance record where their presence increased by 30%. Secondly, the communication between the nurses was addressed by introduction of training classes and making them involved in groups. Moreover feedback exchange sessions are also considered where the nurses would point the positive and negative aspects of their colleagues increasing transparency. Friedlander and Khan (2016) had stated that the evaluation can be done by monitoring the conversation of services and the interactions they have, gaining feedbacks of the nurses, making them feel questionnaire surveys and others. Decrease in long waiting times, medication errors, disagreements among different nurses and others would give information about the communications among the different nurses. Often educating the nurses in treatments of culturally diverse people in another arena, where improvements of service were required. In this case as well, trainings were done to make them develop the ideas about how to treat culturally diverse population without affecting their cultural emotions. Lieblenner and McConell (2016) has advised that reduction in the number of complaints from such patients and also feedback forms filled by such patients after treatments would help the manger in evaluating the success of the training programs, brochures provided, evidence based articles, online websites and others provided to nurses. Moreover the team members of multidisciplinary team members were individually asked about their concerns, their suggestions were noted and important strategies were taken that ensured proper service to the patients in the healthcare.
Conclusion:
The above experiences in the healthcare sector gave a proper review of how healthcare systems work and how things can be resolved with the help of proper analytical and action skills. These experiences will help in the future endeavors which would come in the way in the future.
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