The quality of healthcare services in hospitals is a cause of great concern from all health care stakeholders. The need to minimize patient mortality has prompted hospitals to initiate and implement practices necessary to improve the quality of healthcare. One of the most significant initiatives to improve the quality of health care in health facilities is the establishment of coalitions. A coalition refers to the collaborative move by groups of local healthcare and responder organizations to effectively prepare for and respond to emergencies. The Coalitions therefore, reflect the identifying factors and the particular needs of the local jurisdictions. Such coalitions facilitate research studies in an attempt to unearth the interventions the hospitals may require to implement in order to provide evidence-based quality care to their patients. Moreover, there are various nurse executive issues that require the concerted efforts of health care groups and responder organizations. One such particular issue is the improvement of rapid response team activation to minimize in-hospital mortality rates. There is a great significance of the improvement of the rapid response team activation in a hospital setting (Buist et al., 2002).
Nurse Executive Healthcare Issue
Effective rapid response team activation has been considered a critical factor in responding to adverse occurrences in hospitals. Nurse executives therefore, strive to come up with practices that are effective and specific to emergency management. Many hospital personnel lack the impetus to appreciate the role of rapid response team activation. This however may be due to lack of clear criteria for rapid response team activation. Therefore, the nurses may fail to deliver timely activations to the rapid response team leading to eventual loss of lives of the patients involved.
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To ensure that the rapid response system of a hospital is relevant and practical in the initiation of timely and effective rapid response team activation, there are several critical factors that should be considered. The main tenets of such a program are mitigation, preparedness, response and recovery. As such, vulnerability assessments should be done to ensure that informed decisions are made concerning all the critical factors in a rapid response program employed.
The mitigation aspect refers to all activities made by the nurses and physicians to eliminate the occurrence of adverse clinical cases in a hospital or reduce the impact of the occurrence. Therefore, the hospitals should carry out activities that will reduce the impact of such occurrences in advance. Moreover, mitigation forms a basis for the development of effective and appropriate criteria for analyzing and managing medical emergencies. Additionally such an initiative will help to sustain continuity of service delivery despite occurrence of hazards.
Preparedness is another phase that the nurse executives should consider to ensure that effective measures are put in place to counter medical emergencies. Appropriate and specific policies and procedures should be developed and implemented to assist the nurses and other hospital personnel to initiate timely rapid response team activation (Henderson et al., 2009). Emergency preparedness helps to reduced uncertainties in handling emergency clinical cases. Hypothetical analyses should be done in order to establish patterns and effective routines that improve the rapid response programs.
Effective response mechanisms are also essential in implementing effective rapid response procedure in the health facilities. The activities performed address the immediate and short term effects of emergencies should be based on empirical evidence to minimize the extent of the adverse occurrences. The nurse executives should therefore analyze historical data relating to specific emergencies in order to establish best practices. The impact of the adverse occurrences should be anticipated and the necessary control mechanisms put in place. The long term effectiveness of a rapid response reduce with time if there is lack of regular and continuous implementation of educational interventions to improve the awareness and performance of physicians, nurses and ward staff (Campello et al., 2009). It is therefore worth noting that rapid response team activation practices and procedures are highly a collective responsibility that need objective and focused teamwork.
The final aspect of the rapid response management program is recovery. These are activities that enable the organizations to return to their usual baseline operations or adopt new rapid response management approaches that are current, effective and appropriate. The recovery aspect of the rapid response system aims to sustain the continuity of emergency service delivery in healthcare facilities (Solomon et al., 2016). This is because hospitals provide critical healthcare services as well as the need to maintain a safe environment for patients, nurses and visitors.
To achieve the objectives of any rapid response management strategy, the nurse executives should encourage organization culture and workflow change. The effectiveness of the rapid response programs is primarily influenced by the culture and workflow in a particular organization. The nurses usually wait for up to three vital signs of an imminent adverse occurrence among patients before activating the rapid response team (Campello et al., 2009). The approach is not only ineffective but subjective as different patients exhibit diverse clinical conditions and trends depending on their natural endowments. This moreover, underscores the fact that standardized criteria are not effective. Instead, case by case analysis should be done to avoid ambiguity and error in handling emergencies.
Critical Stakeholders in the Success of the Coalition
The success of any coalition is determined by the commitment of the stakeholders. The stakeholders identified are the organization, rapid response team, research and development team, nurses and ward staff and the private organizations that donate funds and the relatives of the patients. The stakeholders need to understand their individual roles as well as appreciating the significance of rapid response team activation in improving healthcare quality.
The organization executives approve and allocate resources for implementation of rapid response system in healthcare facilities. As such, they play a pivotal role in providing leadership and motivation to the team involved in rapid response management. The executives should therefore communicate their commitment to the implementation of the programs fully and effectively to the nursing executives and other personnel (Campello et al., 2009). This gesture by the executives promotes acceptance and goodwill from all active players in the implementation chain. Executives should also facilitate design, development and institution of effective workflow policies in conformity to the proposed coalitions.
The rapid response team should also be empowered and their role outlined as they are the primary conduits of rapid response management in hospitals. Enough information based on empirical studies should be relayed to them on regular basis. Moreover, they should be educated on the effective intervention mechanisms and approaches aimed at attaining the objectives of the coalition in improving the state of rapid response systems within the local jurisdictions (Henderson et al, 2009). The rapid response team should also be equipped with the necessary specialized equipment and expertise. This ensures seamless coordination and execution of emergency practices effectively.
The research and development team is critical in obtaining the appropriate information necessary in designing the essential infrastructure for responding to medical emergencies in hospitals (Henderson et al., 2009). The research team conducts objective studies on patients and the effectiveness of the prevailing policies and procedures in addressing specific medical emergency situations. Therefore, they should be supplied with the necessary resources and equipment for recording analyzing and presenting accurate and applicable information. Accurate information is relevant in developing effective rapid response team activation criteria.
The nurses handle the patients’ issues in the hospitals pertaining diagnosis, management and treatments. As such, they are critical in identifying vital signs that warrant activation of the rapid response team. Appropriate culture and workflow should be implemented in conformity to the rapid response programs developed and implemented (Santamaria et al., 2010).
The ward staff and the relatives of patients contribute constructively in implementing emergency management programs. It is important to factor in their significance in the coalition initiative. They should be educated and made aware of the vital signs to look out for in patients and communicate to the nurses and even to the rapid response team if appropriate.
The private organizations of goodwill facilitate the success of the coalition because they help in donating funds for use in the research, design and development of appropriate policies and procedures. Private organizations promote awareness about the importance of such systems in the improvement of the quality of healthcare as well as the skills of the personnel involved (Robb et al., 2010). Therefore, the coalitions should factor in the importance of the governmental and private organizations’ role in the implementation matrix. Most importantly, many coalition initiatives are limited by financial constraints,, which can be sorted out by engaging such organizations.
Effectiveness of the Coalition
The coalition proposed is effective as it has very objective course. Furthermore, the stakeholders are identified and their roles specified. The effect of coalition in rapid response systems is immense given the leverages of diverse expertise and pooled resources necessary to develop appropriate policy and practice procedures (Solomon et al., 2016). It is therefore worth indicating that coalitions are essential in solving practical and theoretical issues in health care settings.
Strategic Plan
The objective of the coalition is to develop accurate and appropriate criteria for activation of the rapid response team. The specific objective of the plan is to reduce in-hospital mortality rates regarding patients with deteriorating conditions. The plan will be spearheaded by the rapid response management committee and the program implemented within six months. The plan will be evaluated by the quality improvement team within the rapid response management committee. The reduction in the number of patient deaths and improvement in the quality of healthcare will be the positive success indicators.
Conclusion
In conclusion, coalitions are essential in championing the development of the most effective criteria for activation of rapid response team. The relevant stakeholders should be identified and be actively involved in the process of initiating the necessary change. Additionally, the policies and procedures implemented should be specific to the emergency situations and facilities.
References
Buist, M., Moore, G., Waxman, B., Anderson, J., (2002). Effects of a medical emergency team on reduction of incidence of and mortality from unexpected cardiac arrest in hospital; preliminary study. Buist medical journal, 387-90
Campello, G., Granja, C., Carvalho, F. (2009). Immediate and long term impact of medical emergency team responses to reduce hospital cardiopulmonary arrests, Critical Care Medical, 37 (12), 3054-61
Henderson, D., Malanoski, M., Corapi, G., et al. (2009). Bethesda Hospitals' Emergency Preparedness Partnership: A Model for Transinstitutional Collaboration of Emergency Responses. Disaster Medicine and Public Health Preparedness, 3 (3):168-73.
Robb, G., Seddom, M. (2010). A Multifaceted Approach the Physiologically Unstable Patient, Quality Health Care, 19 (5), 47
Robb, G., Seddom, M. (2010). A Multifaceted Approach the Physiologically Unstable Patient, Quality Health Care, 19 (5), 47
Santamaria, J., Tobin, A. (2010). Changing cardiac arrest and hospital mortality rates through a medical emergency team takes time and constant review, Critical Care Medical Journal , 38 (2), 445-50
Solomon, R., Corwin, G., Barclay, D. (2016). Effectiveness of rapid response teams on rates of in-hospital cardiopulmonary arrest and mortality: A systematic review and meta-analysis. Journal Hospital Med, 11 (6):438-45
