Capella FPX 4010 Interview and Interdisciplinary Issue Identification

Capella FPX 4010 Interview and Interdisciplinary Issue Identification

Interview and Interdisciplinary Issue Identification

Summary of the Interview

The interview was carried out on a nurse colleague using the interview guides provided prior to the interview. The nurse, Ms. Thomas, has been an active nurse for the past five years. In the interview, Nurse Thomas asserted that she has participated in some of the changes occurring in her healthcare facility. Although Nurse Thomas has not been in employment for long, she has seen some transformative changes in the nursing industry and has also actively participated in instituting some of the changes in her healthcare facility. Based on her five years of experience and the changes she has witnessed, interviewing Ms. Thomas was a worthwhile activity.

Capella FPX 4010 Interview and Interdisciplinary Issue Identification

During the interview, Nurse Thomas divulged to the interviewer that she has identified numerous healthcare solutions that she felt would revolutionize her healthcare organization through provision of quality care. The nurse said that some of the changes like technology has transformed the nursing profession to unimaginable levels within the last few years. Ms. Thomas also told the interviewer that in her years of work as a nurse, she has seen some revolutionary innovations within the nursing industry that have transformed the nursing practice from what it was some years back. Capella FPX 4010 Interview and Interdisciplinary Issue Identification

Some of the strategies used to enhance the quality of the interview include effective communication such as clarity and using simple language. The interviewer used simple English language throughout the interview to eliminate chances of miscommunication or misunderstandings related with difficult jargons. Besides, the questions asked were straight forward and simple to get as much information as possible.Capella FPX 4010 Interview and Interdisciplinary Issue Identification

One of the changes that Nurse Thomas admitted having witnessed over the past five years of her professional life as a nurse is the improvement in patient outcomes and quality care. In particular, the nurse quoted efficiently functioning systems and technology as some of the factors that have led to rapid change in the healthcare industry. In the case of systems, Ms’ Thomas said she has witnessed many healthcare facilities reforming their organizational structures to adopt management approaches that promote efficiency and the provision of quality care to patients. Capella FPX 4010 Interview and Interdisciplinary Issue Identification

On technology, the Interviewee lauded such technological advances as artificial intelligence, robotics, nanotechnology, and Electronic Health Records as having brought about fundamental changes to her facility and the industry at large. During the interview, Ms. Thomas gave the example of how EHR technology has made the lives of nurses easy by saving them time and energy.

However, Ms. Thomas also admitted during the interview that even with the advancements brought by technology, there were still some challenges that needed solution. Ms. Thomas particularly decried the issue of rising costs to patients occasioned by technology. She asserted that some hospitals have had to increase their costs and charges to patients to cater for the costs of purchasing and maintaining nursing technology tools.

Secondly, Ms. Thomas asserted that not only is technology expensive for many hospitals, it is also impossible for healthcare facilities to keep changing their equipment with the arrival of newer technology. For this reason, Ms. Thomas told the interviewer that very many healthcare facilities are still stuck in the old way of doing things. Capella FPX 4010 Interview and Interdisciplinary Issue Identification

Issue Identification

Technology has been identified as one of the factors contributing to rapid changes in the healthcare sector. Technology in the healthcare industry leads to improved patient outcomes and quality care. Technology has also led to the reduction of medical errors as its precision improves with each new day. However, technology has also brought some challenges such as increased cost of medical care for patients. Capella FPX 4010 Interview and Interdisciplinary Issue Identification

Change Theory

Change is inevitable for healthcare facilities because of the emerging trends. A simple yet effective change theory that healthcare industry players can utilize to keep up with the current trends is the Kurt Lewin change theory. This theory adopts a three-pronged approach to initiating change. The three stages involved in the Kurt Lewin’s change are: unfreezing, changing and refreezing (Deborah, 2018).

Unfreezing is bringing in the desired values, behavior, beliefs, and organizational culture. Changing stage is the stage where people/organizations transit from the old way of doing things to the new way of doing things instituted at the unfreeze stage. The last stage, refreezing is where the new changes are reinforced and solidified as the new way of doing things.

Collaboration

Collaboration is critical in the healthcare industry because it enhances the quality of care for patients. Where Interprofessional in the healthcare work collaboratively, there is improved healthcare (Carney et al., 2019 Capella FPX 4010 Interview and Interdisciplinary Issue Identification). Collaboration helps health professionals to become better at what they do through discussions, education, and teaching each other. For patients, collaboration between health care professionals lead to improved outcomes and quality care.

Leadership

To solve the identified problems and other problems bedeviling the healthcare facilities, effective nursing leadership is required. Some of the factors required to demonstrate good nursing leadership include skill-based nursing, effective communication, making proper decisions, and positively influencing all employees to adopt positive behavior, culture, values, and philosophies that positively impact on the quality of care provided to patients (Hussain et al., 2018). These factors impact on the quality of care to patients as well as improving patient outcomes such as patient satisfaction.

Capella FPX 4010 Interview and Interdisciplinary Issue Identification References

Interview and Interdisciplinary Issue Identification

Interview Summary

The interview takes place at the Villa Health Network’s Clarion Court Skilled Nursing Facility. As a messenger for Villa Health’s central QA office, I am tasked with interviewing facility staff members about the implementation of a new electronic health record (EHR) system that was fraught with adversities. My role is thus to speak with staff members from both the management and patient care sides, learning about their perspectives on what went wrong and the lessons learned from the situation.

The organization’s problem was that it had an outdated health records system that needed to be upgraded. However, the facility did not have the autonomy to select an EHR that best suited their needs but was coerced into using the Healthix by the Villa health central administration. The problems stemmed from the facility’s lack of autonomy over the implementation project.

The organization’s actions were not independently initiated by the facility’s staff but rather by an implementation coach sent by the Villa health network. The implementation couch employed authoritarian leadership, in which Clarion Court employees were coerced into performing tasks as delegated. This did not sit well with some employees, particularly those in the IT department, who boycotted the duress and went on strike.

Concerning organizational culture, employees reacted positively to the news that a new EHR would be implemented, believing that it would free them from the challenges of the antiquated paper-based documentation system. However, due to a lack of appropriate training on the yet-to-be-implemented technology, they loathed the entire process, resulting in a failed implementation initiative.

Furthermore, some, particularly nurses, with a Luddite attitude contributed to the failure of complementation, which is a culture that must be forestalled. To ensure enough information was gathered, I used open-ended questions that allowed interviewees to further explain themselves and delve deeper into the issue.

An Issue from the Interview in which an Interdisciplinary Approach is Required

The problem at Clarion Court stems from the authoritarian rule of the implementation couch, Josh. Josh, as an outsider from Baltimore, does not understand the issues at Clarion Court and thus lacks the moral authority to lead people through an implementation project at the facility.

Furthermore, he disregards the Clarion Court employees’ opinions, which leads to animosity between him and the local employees. According to the ethical decision-making model, it would be morally justifiable to choose someone from the facility to oversee the implementation process because they are aware of the situation and its gravity at the facility.

Respect, effective communication, and collaboration are essential for an effective interdisciplinary force. If the implementation coach had respected the Clarion Court employees’ decisions, established a proper communication platform, and viewed them as partners rather than inferior accomplices, the environment could have fostered a productive workforce. An effective interdisciplinary force would thus, in addition to promoting the relationship between the employees and the coach, result in a better and more expedited implementation process with improved outcomes.

According to Amend et al. (2022), to achieve an overarching goal of EHR implementation, the perspectives of relevant stakeholders must be considered. It is thus critical to identify the opportunities and potential challenges suggested by stakeholders, the majority of whom are Clarion Court care providers and patients.

Potential Change Theory

Change is the only constant in the healthcare industry, and as the adage goes, change is inevitable. Technology has arguably played a significant role in the healthcare revolution, from the old methods of operation to the current epoch, where almost all departments within a hospital are technologized.

According to Errida and Lotfi (2021), potential drivers of change include new technologies, policies that support a change, economic factors such as increased flow of funds and spending, and social factors such as an individual’s age attitude toward change, and diversity. Keeping the factors in mind, an individual, or more specifically, the change agent, can progress from being aware of innovation to confirming the decision to adopt or reject the idea, ushering in the concept of innovation diffusion change theory.

Roger’s theory, known as the innovation diffusion theory, is distinguished by the fact that even if the change process fails, the change can be resurrected at a later and more appropriate time or in a more appropriate form (Mohammadi et al., 2017). Furthermore, Roger emphasizes the importance of involving key people in the change process, such as policymakers and various funders.

The theory is divided into five steps, which are as follows: (1) knowledge of innovation, (2) persuasion in which the person actively seeks information about the innovation (3) decision, in which the individual weighs the benefits and drawbacks of implementing the change, (4) implementation, which entails the actual process of transforming the idea into reality, and (5) conformation, in which the individual finalizes the decision to continue using the innovation (Mohammadi et al., 2017).

The theory promotes interdisciplinary collaboration, as evidenced by the inclusion of people in each of the five phases described. In the case of the Clarion Court facility, the implementation phase was faced with several challenges halting its progress. Owing to its publishment within the last five years, addressing an evidence-based practice model for the Rogers innovation diffusion theory, and being authored by real change implementers in the nursing field, the article provides credible and reliable information.

Leadership Strategies that could lead to an Interdisciplinary Solution

Almost every aspect of an organization’s operations is influenced by its leadership. While supportive leadership results in a more productive workforce and improved organizational performance, the opposite is also true. In healthcare, a combination of democratic and transformational leadership is the best strategy for achieving care delivery goals. While a democratic leader seeks and uses the opinions of colleagues to effect management, a transformational leader affects change in individuals and systems (Abdullahi et al., 2020).

A democratic leadership facilitates an interdisciplinary solution by encouraging all employees to participate in decision-making. In contrast, transformational leadership does so by instilling valuable and positive change in employees, thereby impacting their productivity. The article provides trustworthy information about nursing leadership strategies and was published within the last five years, making it a credible source.

Collaborative Approaches relevant to establishing an Interdisciplinary Team to address the Organizational Issue

Collaboration in healthcare necessitates the participation of various professionals to achieve agreed-upon patient care goals. Good communication, mutual respect between employees and the implementation coach, and an aspect of negotiation are collaborative approaches that would be effective at Clarion Court. First, communication is a critical pillar in collaboration because it is the only link between people and, if not well orchestrated, leads to a breakdown in the implementation process, as demonstrated at Clarion Court (Boyle et al., 2019). Respecting one another is beneficial to the implementation’s progress and promotes a productive workforce.

Furthermore, negotiating the time when tasks are completed, how they are executed, and what is required to complete them is critical in reducing the burden on employees (Boyle et al., 2019). The fallout between Clarion Court employees and the implementation coach was caused by a breakdown in communication, a lack of mutual respect, and a failed negotiation. Boyle et al. (2019), in addition to being published within the last five years, discusses a current issue, the role of an interprofessional approach to EHR implementation, and is thus a credible and relevant source.

Conclusion

Change drivers can be found in various forms, including social and economic factors, the environment, policies, and the political interface. Even if there is no appropriate time for change implementation, favorable essentials such as capital, technology, workforce, and people’s attitudes should be considered as the bare minimum of implementing a change.

Technology has been a boon in the modern era, contributing to massive revolutionary advancements in the health sector. This is evident at the Clarion Court Skilled Nursing Facility, which is concerned about its outdated health records system and needs an upgrade. A lesson learned is that if there is a need to implement change in the future, care should be taken not to involve outsiders in running a whole implementation program that they are incognizant of.

References

  • Abdullahi, A. Z., Anarfo, E. B., & Anyigba, H. (2020). The impact of leadership style on organizational citizenship behavior: do leaders’ emotional intelligence play a moderating role? Journal of Management Development, 39(9/10), 963–987. https://doi.org/10.1108/jmd-01-2020-0012
  • Amend, J., Eymann, T., Kauffmann, A. L., Münch, T., & Troglauer, P. (2022). Deriving facilitators for electronic health record implementation: A systematic literature review of opportunities and challenges. https://aisel.aisnet.org/ecis2022_rp/81/
  • Boyle, D. K., Baernholdt, M., Adams, J. M., McBride, S., Harper, E., Poghosyan, L., & Manges, K. (2019). Improve nurses’ well-being and joy in work: Implement true interprofessional teams and address electronic health record usability issues. Nursing Outlook, 67(6), 791–797. https://doi.org/10.1016/j.outlook.2019.10.002
  • Errida, A., & Lotfi, B. (2021). The determinants of organizational change management success: Literature review and case study. International Journal of Engineering Business Management, 13, 184797902110162. https://doi.org/10.1177/18479790211016273
  • Mohammadi, M. M., Poursaberi, R., & Salahshoor, M. R. (2017). Evaluating the adoption of evidence-based practice using Rogers’s diffusion of innovation theory: a model testing study. Health Promotion Perspectives, 8(1), 25–32. https://doi.org/10.15171/hpp.2018.03

NURS-FPX4010 Interview and Interdisciplinary Issue Identification 3

Interview Summary

The interview was with Ms. Decker (not her actual name). Miss Decker is a unit manager in the medical unit of a teaching and regional hospital in my state. She agreed to have the interview with me via zoom meeting due to convenience and time constraints.

The healthcare organization in which Decker works is a big facility that offers inpatient and outpatient care in pediatric, medical, surgical, obstetric, oncological, dental, and psychiatric care. Her unit, the medical unit, has the largest bed capacity and the number of nurses and other healthcare workers in the hospital.

As a unit manager, she has leadership and management roles in the unit that involves both direct clinical and administrative duties. She oversees the quality improvement projects and answers directly to the chief nursing executive, the overall coordinator of care quality and patient safety in the healthcare organization.

More than 18 months ago, her healthcare organization was recording increasing incidences of medication errors despite having implemented Epic® electronic health records technology to improve patient safety and care quality more than six years ago. Therefore, the quality team convinced the hospital budgetary and administrative team to implement new technology, barcode medication administration (BCMA) systems.

Eighteen months after BCMA implementation, the healthcare organization still recorded a high number of medication errors. From the interview, she also said that the quality team of which she is a member plans to sit next month to discuss these quality outcomes and plan the next steps. Her organizational administrative culture encourages communication and collaboration between various healthcare professionals involved in direct care and those providing auxiliary services.

Whenever patient safety is at risk, healthcare professionals are allowed to report these incidences for immediate preventive action to their unit managers first before involving higher administrative personnel in the facility. Ms. Decker has had to communicate with other unit managers to compare implementation strategies and share ideas with other departments regarding patient safety and care quality. As a nurse leader, she is also a member of an interdisciplinary team that works with the office of the chief nursing executive to promote care quality.

Issue Identification

The use of technology has been associated with improvement in care quality. However, not all time does this quality results after the implementation of these technologies. Other factors, both human, system, and medication-related, impact the quality outcomes, especially in medication error prevention. From this interview, the clinical issue concerned the lack of achievement of goals of patient safety improvement using additional technology.

According to Al-Ahmadi et al. (2020), medication errors are usually multifactorial and multidisciplinary in etiology and risk factors in the same setting or the same patient situation. The problem, being a multidisciplinary clinical issue, an interdisciplinary approach could offer better outcomes.

From my interviewee’s practice setting, the medication use and treatment process involve not only nurses and doctors but also pharmacists, informaticists, and technologists. The patient still remains the chief stakeholder in medication use. Issues such as policy deviations, distractions, usability, and consistency in technology greatly affect the outcomes of technology in medication error prevention (Mulac et al., 2021; Rasool et al., 2020). Therefore, an interdisciplinary approach would be appropriate for this issue.

Change Theories That Could Lead to an Interdisciplinary Solution

Kotter’s Change Management Model is a potential theoretical model that would be used to develop and facilitate an interdisciplinary team in finding a solution to this issue. This theory emphasizes creating a sense of urgency and forming a coalition that would lead to short-term wins. This theory would be appropriate for this clinical issue because it would bring together all stakeholders by creating the need and urgency for a team approach.

Such intervention would incorporate the aforementioned human and system factors that lead to medication errors. A systematic review study by Harrison et al. (2021) assessed various change models and nursing and healthcare practice and found that Kotter’s model applied to both direct care and management situations in facilitating change. This source is peer-reviewed, current, and authoritative and provides relevant and reliable findings. Therefore, it is a credible source.

Leadership Strategies That Could Lead to an Interdisciplinary Solution

Leadership strategies that would help in developing an interdisciplinary solution are open communication and collaboration, provision of education and training, encouraging team diversity and inclusivity, and shared decision-making. These strategies promote a team approach by bringing together all stakeholders with a common goal.

Utilizing Kotter’s change model would be possible when these strategies are employed by the nurse leader. Creating a sense of urgency in the coalition would be facilitated by communicating, sharing, and setting goals among a diverse group from relevant disciplines.

According to Caulfield and Brenner (2020), engaging patients and their families require that health professional deliver education with objectives targeting medication error prevention. Involving a group of different professionals provides multidisciplinary prevention. This source was from a retrospective clinical research published in a peer-reviewed journal called BioMed Central. This source is also credible because it is current and relevant.

Collaboration Approaches for Interdisciplinary Teams

Interdisciplinary rounding, case conferences, and shared decision-making are three approaches that would be useful in creating and improving interdisciplinary teams. Interdisciplinary rounding would promote face-to-face interaction between nurses, pharmacists, and prescribers to discuss specific patient cases and implement together strategies to prevent medication errors. During these rounds, shared decision-making can be made possible.

At higher leadership levels, it is advisable to use case conferences to promote patient-centered care by focusing on patient-specific strategies in interdisciplinary meetings. Implementing Shared decision-making for this during conferences and interdisciplinary rounding would ensure that the process for transition between the prescriber, the dispenser, and the medication administrator is name possible through direct physical communication. Chances of medication errors are therefore reduced by timely and effective communication.

According to a qualitative study by Salar et al. (2020), some of these strategies promote professional actions and presenting technical strategies among interdisciplinary teams. This source interviewed healthcare professionals and is peer-reviewed. The content and findings relate to what we see in practice today and are thus valid. Overall, it is a credible source.

Conclusion

Medication error prevention using technology may not be foolproof. Consideration of different factors requires the incorporation of interdisciplinary actions. In this healthcare issue, the problem was the underachievement of medication prevention goals despite using technology. The interdisciplinary approach would promote the finding of a solution through Kotter’s change management model, communication and collaboration, provision of education and training, encouraging team diversity and inclusivity, and shared decision-making in nursing leadership.

Interdisciplinary rounding, case conferences, and shared decision-making are approaches that would promote interdisciplinary collaboration. Credible sources have been used to back up the argument for these strategies because these sources are current, authoritative, relevant, accurate, and purposeful.

References

  • Al-Ahmadi, R. F., Al-Juffali, L., Al-Shanawani, S., & Ali, S. (2020). Categorizing and understanding medication errors in hospital pharmacies concerning human factors. Saudi Pharmaceutical Journal: SPJ: The Official Publication of the Saudi Pharmaceutical Society, 28(12), 1674–1685. https://doi.org/10.1016/j.jsps.2020.10.014
  • Caulfield, J. L., & Brenner, E. F. (2020). Resolving complex community problems: Applying collective leadership and Kotter’s change model to wicked problems within social system networks. Nonprofit Management & Leadership, 30(3), 509–524. https://doi.org/10.1002/nml.21399
  • Harrison, R., Fischer, S., Walpola, R. L., Chauhan, A., Babalola, T., Mears, S., & Le-Dao, H. (2021). Where do models for change management, improvement, and implementation meet? A systematic review of the applications of change management models in healthcare. Journal of Healthcare Leadership, 13, 85–108. https://doi.org/10.2147/JHL.S289176
  • Manias, E., Street, M., Lowe, G., Low, J. K., Gray, K., & Botti, M. (2021). Associations of person-related, environment-related and communication-related factors on medication errors in public and private hospitals: a retrospective clinical audit. BMC Health Services Research, 21(1), 1025. https://doi.org/10.1186/s12913-021-07033-8
  • Mulac, A., Mathiesen, L., Taxis, K., & Gerd Granås, A. (2021). Barcode medication administration technology use in hospital practice: a mixed-methods observational study of policy deviations. BMJ Quality & Safety, 30(12), 1021–1030. https://doi.org/10.1136/bmjqs-2021-013223
  • Rasool, M. F., Rehman, A. U., Imran, I., Abbas, S., Shah, S., Abbas, G., Khan, I., Shakeel, S., Ahmad Hassali, M. A., & Hayat, K. (2020). Risk factors associated with medication errors among patients suffering from chronic disorders. Frontiers in Public Health, 8, 531038. https://doi.org/10.3389/fpubh.2020.531038
  • Salar, A., Kiani, F., & Rezaee, N. (2020). Preventing the medication errors in hospitals: A qualitative study. International Journal of Africa Nursing Sciences, 13(100235), 100235. https://doi.org/10.1016/j.ijans.2020.100235

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