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NURS FPX 6212 Assessment 3 : Outcome Measure, Issues, and Opportunities

Assessment 3: Outcome Measure, Issues, and Opportunities

Name

Capella University

NURS-FPX 6212

Dr. Name

March, 2024

Outcome Measure, Issues, and Opportunities

Outcome measures are essential for assessing the success of various interventions, treatments, or programs in meeting their objectives. These measures have been instrumental at Vila Health Hospital in enhancing the quality and safety of healthcare services. Vila Health’s management team has conducted thorough analyses of the repercussions of staff shortages, which include increased employee burnout, turnover, job dissatisfaction, medication mishaps, and compromised patient care. Through these outcome measures, the organization has pinpointed critical shortcomings and fostered ongoing improvements. In response to the challenges of staffing deficits, implementing a patient acuity or workload management system is a viable technological solution. Such systems incorporating algorithms and data analytics can determine each patient’s care needs. They consider factors like diagnosis, illness severity, and required treatments (Gan et al., 2020). This approach enables a more tailored assessment of staffing needs, promoting more efficient and effective healthcare provision.

Analyze Organizational Functions, Processes, and Behaviors 

Highly successful organizations distinguish themselves through several key traits, including superior outcomes, robust employee engagement, and enhanced efficiency and effectiveness, outshining their competitors. Vila Health’s challenges, such as an effective workforce, lack of technological savvy, and inefficient collaboration due to staffing shortages, potentially lead to negative outcomes.  In addressing staff inadequacies, effective organizations employ specific strategies in their operations, processes, and behaviors. One crucial aspect is advanced workforce planning systems, enabling accurate estimation of staff needs and resource allocation. This strategic planning is a hallmark of efficient organizations, ensuring they meet demands without overstraining resources.

Moreover, high-performing entities leverage technology and automation for optimal staff utilization, reducing workload pressures. Implementations might include artificial intelligence for patient triage, telemedicine for broader care access, and automated tools for administrative tasks. These technological advancements streamline operations, enabling staff to focus on more critical tasks. Employee engagement and retention are other focal points for these organizations. By investing in programs that enhance job satisfaction and work-life balance, such as professional development, flexible work options, and fostering a positive work environment, these organizations ensure a committed and content workforce. This approach includes monitoring staffing levels and patient outcomes, enabling timely interventions to address staffing issues. Lastly, a culture of collaboration and teamwork is pivotal. In such environments, employees collectively pursue shared objectives and support each other in delivering top-quality care. This cooperative ethos not only boosts morale but also enhances overall organizational performance (Dall’Ora et al., 2020). 

Knowledge Gaps and Uncertainties

While it’s recognized that staffing shortages can negatively impact patient care, the extent and specifics of these impacts remain largely unexplored. Exploring how reduced staffing levels affect patient satisfaction, mortality rates, and the frequency of hospital readmissions requires more in-depth investigation. The interplay between an organization’s culture, its staffing, and patient outcomes is a complex one. Despite a growing appreciation of the importance of organizational culture in healthcare settings, the exact nature of this relationship is still unclear. Future research could shed light on the specific cultural traits that define high-performing healthcare organizations, and how these traits influence staffing levels and, subsequently, patient outcomes (Sullivan et al., 2022).

Organizational Functions, Processes, and Behavior Support and Affect Outcome

The role of organizational dynamics, including procedures and behaviors, is crucial in addressing the challenges of insufficient staffing in healthcare settings. By adopting effective human resource strategies, organizations can anticipate potential staffing shortages and implement preventative measures. These proactive steps are vital in lessening the negative impact of limited staffing on patient care, potentially reducing adverse outcomes. Shortages in staff can lead to increased wait times, service delays, and a decline in the quality of care, negatively affecting patient satisfaction. Here, leveraging technology and automation plays a pivotal role. For example, telehealth can extend care access without necessitating increased staff, and artificial intelligence can ease the burden on front-line workers. 

Investing in employee engagement and retention strategies is another critical factor. By focusing on these areas, organizations can lower staff turnover rates, thus improving staffing conditions and overall outcomes. This approach also supports a culture of collaboration, enhancing the team’s ability to work towards common goals and support each other, thereby mitigating the effects of staffing shortages on care quality (Dellafiore et al., 2022). Moreover, communication breakdowns, often exacerbated by inadequate staffing, can lead to misunderstandings and errors, further stressing the importance of a collaborative work environment to ensure high-quality care even in challenging staffing situations.

Underlying Assumptions

Optimal staffing levels are crucial for the highest level of organizational performance. When organizations maintain adequate staffing, employees tend to exhibit higher productivity, engagement, and job satisfaction, as they are not overburdened by excessive workloads. Conversely, when staffing is inadequate, it can negatively impact organizational dynamics, leading to reduced efficiency and effectiveness. Research has consistently shown that organizations with appropriate staffing levels benefit from enhanced productivity, reduced employee turnover, and higher levels of customer satisfaction. This underscores the importance of maintaining balanced staffing as a key component of organizational success (Xu et al., 2021). 

Standard Outcomes in Healthcare Quality and Safety

At Vila Hospital, suboptimal staffing may lead to increased patient waiting periods, delays in care provision, and a drop in care quality. This situation often correlates with longer hospital stays, a higher rate of infections acquired in the hospital, and an increased number of readmissions. A critical concern is the elevated risk of medication errors, which pose significant safety and quality challenges for Vila Health. Additionally, such staffing challenges can contribute to employee burnout, negatively impacting morale and the quality of care delivered.

Employee burnout often leads to high turnover rates, increasing recruitment and training costs for Vila Health. Addressing these staffing issues can involve several strategies:

  • Tracking patient satisfaction scores at Vila Health can reflect the perceived quality of care, with declining scores potentially highlighting negative effects of staff shortages on patient outcomes.
  • Monitoring the frequency of medication errors provides insights into the safety and quality of care, where an increase might suggest staffing issues as a contributing factor.
  • Analyzing staff injury rates helps identify areas with increased risks due to inadequate staffing, with higher rates indicating the need for staffing adjustments to reduce injury risks. 
  • Observing staff turnover rates aids in understanding the effects of staffing levels on employee burnout and retention, with increasing turnover suggesting a need for changes in employment levels to enhance job satisfaction and reduce burnout (Feng et al., 2022).

Evaluation of Quality of the Data

The prevalence of hospital-acquired infections (HAIs) in the United States is an ongoing concern, with the CDC reporting a rate of about 3.2% for all hospital stays. The specific target rates for HAIs vary based on the type of infection, but the overall aim is to lower their occurrence across healthcare facilities. HAIs are a significant focus for healthcare institutions, not only due to their impact on patient health but also because of the associated costs and resource use​​​​. The hospital mortality rate in the U.S., standing at roughly 0.9%, is another critical metric, indicating the overall effectiveness and safety of healthcare. In parallel, medication errors represent a substantial issue, with estimates suggesting that 5-10% of all drugs in U.S. hospitals are administered incorrectly. These errors can have serious implications for patient safety and healthcare outcomes (Dellafiore et al., 2022). 

In terms of workforce dynamics, the turnover rate for registered nurses in the U.S. is reported to be about 17.2%. High turnover rates can reflect issues such as job dissatisfaction or workload stress, impacting the continuity and quality of patient care. On the patient experience front, satisfaction levels in U.S. hospitals hover around 72%, though individual healthcare organizations might have different benchmarks for desired satisfaction rates. High patient satisfaction is often correlated with better clinical outcomes and reduced readmission rates (Hodkinson et al., 2022).

A study published in the Journal of Hospital Medicine underscores the impact of nursing shortages on the completeness and quality of documentation in hospital electronic medical records (EMRs). These shortages lead to insufficient documentation, which can negatively influence the quality of data used for clinical decision-making. Accurate and complete documentation in EMRs is vital for ensuring effective patient care and safe clinical practices. Therefore, addressing nursing shortages is not only about numbers but also about maintaining the quality of patient care documentation and data integrity, which are critical for clinical decisions and patient outcomes

Challenges and Prospects in Organizational Effectiveness

Short staffing can significantly impact an organization’s operations, affecting everything from staff performance to client satisfaction. When there aren’t enough employees to handle the workload, those who are present may become overburdened. This increased stress can lead to a drop in productivity, with potential outcomes like missed deadlines and incomplete tasks. Overworked staff may rush through their duties, raising the likelihood of errors. The strain of working in an understaffed environment can also affect employee morale. Workers might feel unsupported and overwhelmed, which can lead to reduced job satisfaction and motivation, as well as increased absenteeism and turnover rates. On the customer side, insufficient staffing can result in longer wait times, delays in service, and less personalized attention, which can, in turn, lower customer loyalty and satisfaction (Khatatbeh et al., 2022). Addressing staffing challenges is not only about filling positions but also about improving organizational performance and adhering to higher quality and safety standards. Effective staffing strategies can help organizations optimize their operations, enhance employee well-being, and improve customer experiences.

Areas for Further Research

Boosting staffing levels can improve organizational performance, but this must be balanced against the costs. The rise of remote work, particularly during the COVID-19 pandemic, has further complicated staffing decisions, impacting workforce needs and efficiency. The long-term effects of this shift on staffing, engagement, and productivity are still unfolding. Organizations are exploring different models like temporary staffing and outsourcing to address staffing shortages while balancing cost and effectiveness (Deng et al., 2022).

Approach for Comprehensive Measurement of Patient Care Aspects 

Applying Lewin’s Change Management Model, a plan can be formulated focusing on comprehensive patient care assessment and encouraging knowledge sharing among staff, particularly in situations of staffing shortages. The first phase, ‘Unfreezing,’ involves educating staff about the need for change, specifically how inadequate staffing impacts patient care and outcomes. This phase might include using presentations, staff meetings, and internal publications to communicate the urgency for change, addressing staff resistance, and gathering their feedback and suggestions. The ‘Change’ phase entails actively measuring and sharing various aspects of patient care. This step includes monitoring medication errors, patient satisfaction, and clinical outcomes. Developing a framework for data collection and reporting is crucial in this stage. Training staff in measurement methodologies, data collection, and analysis is also integral. Further, sharing patient care data and feedback through interdisciplinary methods such as rounding, case conferences, and clinical huddles is a part of this phase. Finally, the ‘Refreezing’ phase is where these changes are solidified into the organization’s culture to maintain and sustain improvements (Moloney et al., 2020). This includes the integration of the measurement and reporting systems into daily procedures, providing ongoing training about these frameworks to new employees, and recognizing and rewarding staff contributions to enhancing patient care. 

Conclusion

Lewin’s Change Management Model offers a structured approach to addressing workforce challenges and improving patient care metrics in healthcare settings. This model, which encompasses the stages of unfreezing, changing, and refreezing, enables healthcare organizations to create a comprehensive framework for measuring various aspects of patient care. It involves educating and training staff, establishing consistent reporting practices, and ultimately embedding these changes into the organization’s culture. Even in the face of staffing challenges, this model can facilitate the identification of collaborative opportunities across disciplines, aiming to enhance patient outcomes (Sullivan et al., 2022). By systematically applying each phase, healthcare organizations can adapt to and manage changes more effectively, fostering an environment conducive to continuous improvement in patient care. 

References

Dall’Ora, C., Ball, J., Reinius, M., & Griffiths, P. (2020). Burnout in nursing: A theoretical review. Human Resources for Health, 18(1), 1–17. https://doi.org/10.1186/s12960-020-00469-9

Dellafiore, F., Caruso, R., Cossu, M., Russo, S., Baroni, I., Barello, S., Vangone, I., Acampora, M., Conte, G., Magon, A., Stievano, A., & Arrigoni, C. (2022). The state of the evidence about the family and community nurse: A systematic review. International Journal of Environmental Research and Public Health, 19(7), 4382. https://doi.org/10.3390/ijerph19074382

Deng, H., Wu, W., Zhang, Y., Zhang, X., & Ni, J. (2022). The paradoxical effects of COVID-19 event strength on employee turnover intention. International Journal of Environmental Research and Public Health, 19(14), 8434. https://doi.org/10.3390/ijerph19148434

Feng, J., Li, L., Wang, C., Ke, P., Jiang, H., Yin, X., & Lu, Z. (2022). The prevalence of turnover intention and influencing factors among emergency physicians: A National Observation. Journal of Global Health, 12, 04005. https://doi.org/10.7189/jogh.12.04005

Gan, Y., Jiang, H., Li, L., Yang, Y., Wang, C., Liu, J., Yang, T., Zheng, Y., Zhu, Y., Sampson, O., Xu, H., Yu, F., Chen, Y., Herath, C., Zhong, Y., Liu, Q., Yu, M., Liu, L., Gao, C., & Lu, Z. (2020). A national survey of turnover intention among general practitioners in China. The International Journal of Health Planning and Management, 35(2), 482–493. https://doi.org/10.1002/hpm.2921

Hodkinson, A., Zhou, A., Johnson, J., Geraghty, K., Riley, R., Zhou, A., Panagopoulou, E., Chew-Graham, C. A., Peters, D., Esmail, A., & Panagioti, M. (2022). Associations of physician burnout with career engagement and quality of patient care: systematic review and meta-analysis. BMJ (Clinical research ed.), 378, e070442. https://doi.org/10.1136/bmj-2022-070442

Khatatbeh, H., Pakai, A., Al-Dwaikat, T., Onchonga, D., Amer, F., Prémusz, V., & Oláh, A. (2022). Nurses’ burnout and quality of life: A systematic review and critical analysis of measures used. Nursing Open, 9(3), 1564–1574. https://doi.org/10.1002/nop2.936

Moloney, W., Fieldes, J., & Jacobs, S. (2020). An integrative review of how healthcare organizations can support hospital nurses to thrive at work. International Journal of Environmental Research and Public Health, 17(23), 8757. https://doi.org/10.3390/ijerph17238757

Sullivan, D., White, K. M., & Frazer, C. (2022). Factors associated with burnout in the United States versus international nurses. The Nursing Clinics of North America, 57(1), 29–51. https://doi.org/10.1016/j.cnur.2021.11.003

Xu, G., Zeng, X., & Wu, X. (2021). Global prevalence of turnover intention among intensive care nurses: A meta‐analysis. Nursing in Critical Care. https://doi.org/10.1111/nicc.12679

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