Post 3 replies to classmates or your faculty member. Be constructive and professional in your responses (175-WORDS EACH)
- student name: Jennifer Lorenz
[NOTE: THIS FIRST POST IS IN RESPONSE TO MY INITIAL POST.
Thank you for your post. I have a question about the feedback mechanism you have planned for when there are complaints regarding racial profiling or discrimination. Will these issues be going to a “patient satisfaction” type employee or is the plan to have the complaints be dealt with through human resources?
I am curious because personal discrimination on the part of providers is not the single cause of disparities in health care, Causes of racial differences are multi-dimensional. It is interesting to realize the institutional discrimination can be just as strong as individual discrimination. It is also sad to realize that same issue. Because in health care, the geographic locations of medical resources, racial differences in patient preferences, economic status, insurance coverage, trust, knowledge, and familiarity with medical procedures are other reasons for discrimination and racial inequity. How do we in health care, adjust some of those things to decrease the potential for suggested racial disparity?
I also think your project is long term and will require constant education and monitoring. You will be able to affect change on every level as you remain hands on with the employees and the patients. I congratulate you for taking on a significant and important topic for our world. I am also a little sad thinking we will not be connected through school so we can all revel in your success.
Reference
Laurencin, C.T. Unconscious Bias, Racism, and Trauma-Informed Policing: an Address and Message to the Connecticut Racial Profiling Prohibition Project Advisory Board. J. Racial and Ethnic Health Disparities 7, 590–591 (2020). https://doi.org/10.1007/s40615-020-00794-8
- Student name: Marcel Kwaye
Top of Form
What will be required in order to sustain the improvement(s) related to your practicum project?
It is essential to recognize that sustainably is about maintaining the gains of an improvement initiative despite staff and organizational turnover. Hence according to Silver et al. (2016), in order to achieve sustainable changes the improvement initiatives must become the way of working “the new way we do things.”
Practicum Project: Preventing Pressure Injuries by Fostering Staff Engagement and Decision-Making through a Unit-Based Data-Metric System and Team Huddles
The project’s sustainability requires four key components; visual management, standard work, team huddles, and contextual factors. These elements are embedded in the project’s framework and according to the National Health Service Sustainability Model are essential factors necessary for improvement (Silver, 2016).
Visual management: A team huddle board serves as the location of the project’s performance metrics, data, and track/trend progress.
Standard work processes are outlined and discussed daily at the huddle. This work includes a review of and ensuring that current best practices (evidence-based and Lean methods) the consistent application of these practices to every patient encounter.
Team huddles: Huddles occur daily at 0700 and include both night and day shift staff members.
Contextual factors: An analysis of unit data re-enforced the “right setting, right time” for the project.
These factors are discussed daily at the huddle to support continued staff engagement and accountability to prevent patient unit-acquired pressure injuries.
What factors would keep improvements from being sustainable?
Staff buy-in and competing leadership priorities were identified as primary risk factors for the project’s success and sustainability. The project’s risk management register served to identify triggers, the management, a plan, and methods to monitor/track these factors in planning and during implementation. Sustaining improvements depend on leadership support and presence in the process and continued use of wins to build momentum (Kedar & Rakover, 2016). The project’s continued success includes the ability of leadership and frontline staff to address and work through issues that get in the way of the process (standard work), i.e., resources, the need for, and provision of additional training).
Kedar, S., Rakover, J. (2016). Four steps to sustaining improvement in health care. Harvard Business Review.
https://hbr.org/2016/11/4-steps-to-sustaining-improvement-in-health-care
Silver, S., McQuillan, R., Harel, Z., Weizman, A., Thomas, A., Nesrallah, G., Bell, C., Chan, C., Chertow, G. M. (2016). How to sustain change and support continuous quality improvement. Clinical Journal of the American Society of Nephrology: CJASN, 11(5), 916–924. https://doi.org/10.2215/CJN.11501015
- Student name: Lisa Naglack
As I used the ADKAR model of change to help implement my practicum project, I will follow along with the last building block in this model and that is Reinforcement. According to the ADKAR model, reinforcement is necessary in order to ensure that the project is complete, and the change has taken hold. “With effective reinforcement, you avoid losing momentum from the initial deployment of the change and you can prevent employees from reverting to old ways of doing work. By building reinforcement mechanisms, the probability that project objectives are met increases dramatically” (Hiatt, 2006, p. 119). I will implement a couple reinforcement tactics to ensure that staff continue to offer and assist the patients with virtual visits during the pandemic. Recognizing employees that have assisted patients with visits during our daily huddle is a good way to acknowledge the good work that the staff are doing. This is turn will help motivate the staff to continue with the project. Listening to employee feedback is another tactic that will help keep staff motivated and sustain the project. Understanding where the staff are struggling with the virtual visits and making improvements along the way is important to keep the project sustained. Leadership rounds are also important to sustaining the project. Much information is gathered from talking with both the patients and the staff on leadership rounds.
One factor that would stop the project from continuing is staffing. When the unit is short staffed, it is very difficult for the staff to take the time necessary to assist the patients with virtual visits.
Hiatt, J. M. (2006). ADKAR: A model for change in business, government and out community.
Fort Collins, CO: Prosci Learning Center for Publications.
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