Leadership: Task 1

A1: Issue

Effective communication is a vital element in the physician practice. After communicating with the hospital’s manager, nurse manager, among other colleagues, we have identified that poor communication has been an issue in our organization. My proposal is all about training the staff on effective communication. It also involves crafting a process for accurate, effective, and precise communication. In this case, I want to introduce the patient assessment sheet.

A1a. Explanation of the Issue

According to the study that Ranjan, Kumari & Chakravarty (2015) conducted, the physician practice relies on effective communication. In this case, poor communication may result in many issues, including medical errors, delayed diagnosis, and treatment, among other issues. Vermeir et al. (2015) work argue that inefficient communication among physicians results in many issues, including sub-par quality of care and reduced patients’ outcomes. In our organization, we rely on three main modes of communication, including written, verbal, and electronic. For assessments, diagnosis, treatment, effective communication among the medical team is essential. Merlino (2017) notes that effective communication among the medical team reduces medical errors. Communication issues among the staff members in our organization have increased the rate of medical errors, resulting in the patient’s long waiting time, delayed treatment, and incomplete follow-up. It has also resulted in the improper handling of the patients’ private medical data.

A2. Investigation

Effective communication in a hospital setting is a topic that many scholars have explored. In a work that Vermeir et al. (2015) conducted, ineffective communication has profound effects on the patient’s safety. It also affects the nurses’ working relationship and job satisfaction, among other effects.  Masters (2018), in his work, added that between 1995 and 2005, 66% of the medical errors were related to poor team communication. A study by Jones & Groom (2016) also shows a strong correlation between healthcare providers’ effective communication skills and patients’ health outcomes. After realizing that we had a communication issue, I organized for a consultation meeting with the organization’s office manager, director, and the nurse manager, and we all agreed that inefficient communication is the major challenge facing our organization. I also met a couple of nurses in my practice, the scheduler, and the receptionist, and we agreed that communication should be improved.

I also interviewed a couple of staff on the issues they face as a result of poor communication. One doctor narrated an incident where he had requested for a CT-Scan for a patient, and it never happened. Despite this being the patient’s mistake, follow up could have been done. Another nurse argued that he wrote to the scheduler at the check-out section to order for the complete blood count and a comprehensive metabolic panel for a particular patient. Without the physician marking it on the actual check out the paper, the labs were missed. The patient showed up for the appointment without the labs, which delayed the patient’s waiting period. Yet another nurse argued that his patient missed a chemo treatment since he was not told about an appointment. With so many issues related to ineffective communication, a change should be embarked on. If we improve on communication skills, we will prevent medical errors, patient’s frustration, and excessive waiting periods.

A2a. Evidence of the Issue

In their work, Tang et al. (2013) note that poor communication amongst healthcare workers mainly results in work dissatisfaction. It has also compromised on the quality of care, as Jones & Groom (2016) argue. In a journal article by Taran (2011), poor communication among healthcare workers is a leading cause of preventable deaths in the US. On examining the issue, there seems to be no data related to the issue in our office.  However, after examining the three modes of communication in my office, I noted that physicians don’t use a similar process and especially at the check-out section.  Another physician argued that he handwrites on a summary sheet. In some cases, such instructions can be misinterpreted. In other cases, some elements are left off. Instructions written on a generic paper needs a follow-up. Such information includes but not limited to medications, labs, tests, and chemo. The lack of documented information shows that communication is a significant element that should be improved.

A3. Analysis

I examined significant elements of the procedures of connecting with the stakeholders, investigated the issues about the physician process, and interviewed various staff members. From a personal analysis, two main things should be embarked on to improve communication. Firstly, the management should schedule monthly meetings for staff where effective communication thorough training should happen. During this meeting, the stakeholders should discuss various elements that should be improved. Secondly, the management should also come up with a form used from the check-in section to check-out. This form should be used by various physicians.

A3a. Contributors to the Issue

One of the main issues that contribute to poor communication in our organization is the language barrier. As Meuter et al. (2015) note, the language in the healthcare sector leads to miscommunication, which is life-threatening. With the rising numbers of foreign-trained staff, communication errors as a result of a language barrier are inevitable. For instance, in my practice area, we have an Indian physician, and sometimes he faces challenges comprehending directions given by the nurse, scheduler, or even the nurse manager. Another main issue is the fact that the staff members are hesitant to ask for clarification from the physicians. Additionally, when the scheduler is out of the office, the other receptionist has issues scheduling and ordering various items required during the check-out. Analyzing the issues indicated that the primary concern is the fact that the organization lacks a specific procedure from the check-in to the check-out section.

A4. Proposed Solution

This proposal towards solving the communication challenge has two main tasks. Firstly, management should introduce a meeting every month. During these meetings, the staff members can discuss the communication issues that they face and the strategies to eliminate them. The meeting will also offer a platform for training on communication. Secondly, there should be a consistent process that all the staff should understand. The standardized process incorporates a sheet of data, assessments, and instructions that all the patients should follow from checking in to checking out.

A4a. Justification of the Proposed Solution

In a study that Dingley et al. (2011) conducted, the lack of a standardized process and effective communication in a hospital setup can lead to a delay in communication. It also results in inadequate patient care. If all the staff follows a standardized process, the overall patient’s experience and outcomes would be enhanced. Masters (2018), in his work, adds that effective communication and teamwork in a clinical setting improves clinical effectiveness, job satisfaction, as well as patient outcomes. If the management implements monthly meetings and a standardized process, it will lead to positive patient outcomes, reduced medical errors, a reduced waiting period, and job satisfaction among the staff.

A5.  Resources and Cost-benefit Analysis

The implementation of the proposed sheet will only occur after the doctors’ review and agreement. This sheet will be used in patient’s follow-ups. However, the sheets can be modified to fit the specific needs of various patients, including labs, chemo, orders, and medications. Another element that can be added is referrals. I will also require an approval form from the office manager to schedule the hourly meetings every month. Apart from the doctors’ and managers’ approval, I will also require cooperation from my fellow workers. Improving communication in an organization calls for collaborative efforts from all staff members.

Cost-Benefit Analysis

This analysis determines the costs and the benefits of a plan. The costs, in this case, include extra paper, ink, and time for every patient sheet. The estimated costs according to PayScale Salaries (2016) are as follows;

Item	Cost
Carton of paper (5000 sheets)	$75
Ink Cartilage replacement (two packs)	$52.99
Medical receptionist pay (per hour)	$13.21
Medical scheduler pay (per hour)	$14.25
2 Registered nurses pay (per hour)	$56.30
Medical office manager pay (per hour)	$35.00
Nurse Charge pay (per hour)	$30.32

The two physicians and the director in the hospitals are under the monthly salaries, and in this case, they will not receive any payment to come for the monthly meeting. The meeting’s benefit will be assessed through the patient’s safety, service efficiency, and patient-centered care (Vermeir et al., 2015). In his work, Budryk (2016) argues that poor communication leads to approximately 1.7 billion dollars in hospice expenses. The above plan may eliminate such unwanted costs.

A6. Timeline

On 1st July 2020, I need to obtain approval and any budget requests from the organization’s stakeholders. Afterward, the gathering of data and draft making for doctors will be done. The doctor can change the draft to fit their patient assessment elements if necessary. By August 2020, the patient assessment paper will be ready for use. The actual implementation will occur in September 2020, where the office manager will coordinate the monthly meeting.  The monthly meeting will be coordinated through various modes, including verbal and electronic invitations.

A7. Identification of Key Stakeholders

In this proposed solution, various stakeholders will be incorporated. These stakeholders include the nurse charge, three physicians, nurses, scheduler, office managers, and a receptionist.

A7a. Importance of Key Stakeholders

In implanting this proposed solution on effective communication, various stakeholders are vital, as mentioned earlier. For example, all the staffs have a role to play in the implementation. Budget allocation will require the help of both the director and the office manager. The two will also oversee issues to do with the implementation of the recommendations. Drafting the patient assessment task will require collaboration between the nurses, the charge nurse, and three physicians. Such collaboration will assist in coming up with an assessment sheet that will eliminate communication errors.

A7b. Engagement with the Key Stakeholders

I first met the office and nurse manager, charge nurse, and the hospital director, where I presented my proposal. In a one-hour meeting, we discussed how poor communication has affected our practice and how the proposed plan can be of help. During this presentation, I presented the findings from various literature, including books, government websites, and peer-reviewed articles on how poor communication in a healthcare setting can result in detrimental effects.  I also wanted to see whether the other staff were affected by communication issues. After questioning them, I realized that communication presented a significant challenge for all. One physician explained a situation where his patient missed chemo as a result of miscommunication. Another physician argued that one of his patients left before treatment after she waited for her turn for two hours. All the staff agreed that a patient assessment sheet would eliminate or even reduce miscommunication and delayed communication, among other issues.

A7b. Success

For the proposal to work, the collaboration of all the stakeholders is required. After the proposal implementation, I will request the charge nurse to foresee the weekly feedback and communication with the other staff to examine its effectiveness. If the proposal has an issue, the monthly and training meeting will provide a platform to correct it. The office manager has a role of sending monthly meeting email invitations to all staff members. I will later examine compliance and proposal feedback. Examining the feedback will help us see what is working and what can be changed.

A8. Implementation

I will work with the staff members and help them understand the effects of poor communication in our organization. Through such an analysis, the staff will understand the importance of the proposed change. The proposal will be left at the receptionist, where the patient’s check code and the capturing of their demographics will occur. The next destination will be the nurses’ station, where he/she will fill the patient’s information. Example of such information includes the patient’s symptoms, treatment, medications, and complaints. The sheet will also move to the doctor’s office that will fill in after the patient’s examination.  The specialist may fill in a charge code, clinic date, and probably underline or circle tests required and the patient’s new medications. The sheet will then move to the nurses’ station, where the new prescriptions will be gathered in order. The sheet will finally move to the receptionist who schedules the next appointment, if any, schedule tests and put the patient’s charge code.

A8a. Evaluation for Success of Implementation

The evaluation of the proposal will be conducted three months after its implementation. During the first and second monthly meeting, I will collect the feedback. I will collaborate with the other staff members to improve on various recommendations on the feedback forms. However, some recommendations will be discussed during our third meeting. The proposal’s success will be based on the patient’s experiences and staff job satisfaction.

B1: Role of Scientist

In this exercise, the scientist’s role is attained by examining the issue of ineffective communication in our organization. From the examination, I realized that our organization lacked a standardized communication process. I researched the issue from a couple of peer-reviewed articles and realized that it adversely affects many organizations. As Taran (2011) study indicated, miscommunication in hospitals among other healthcare organizations leads to approximately 44,000 to 98,000 deaths annually.

B2. Role of Detective

The detective role was fulfilled by a keen analysis of the issues affecting the organization. I also engaged other staff, and we noted that among other issues, ineffective communication was adversely affecting us.

B3. Role of the Manager of Healing Environment

This manager’s role was played by examining the existing policy based on communication. The changes were well calculated to ensure that they did not cause issues in the hospital or even the physician practice. I also ensured that all the stakeholders were involved. The main goal towards this collaboration and adequate research was to offer a top-notch, excellent, and safe and effective patient care.