Background Information
In a local clinic, patients have been making complaints regarding the quality of care that they receive from healthcare providers. This was mainly in regards to the responses that they obtained from their nurses. Most patients stated that, when questioned about the diseases and conditions of patients, most nurses provide inadequate or incomplete answers.In some cases, there was insufficient education in regards to the treatment regime that some patients had been provided. Physicians within the hospitals had also made complaints of miscommunication regarding patients' conditions by nurses. This provision of inadequate or incomplete follow-up instructions adversely affected the quality of care within the clinic.
Upon assessment, it was identified that this communication breakdown could be attributed to the work culture in the hospital environment. There were several assumptions by the nursing staff that had resulted in familiarity relating to communication. There were no specific components of work culture in place, to facilitate better communication between nurses and their patients; a proper change model has to be structured to ensure better transparency and effectiveness. This is essential as nurse-to-patient communication is critical for quality health care (Crawford, Candlin & Roger, 2017).
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Appropriate Change Model
The McKinsey 7-s model acts as the most appropriate framework that the master’s prepared nurse can apply to this healthcare delivery situation. The model is appropriate as it that analyzes the design of the organization through the assessment of seven critical elements (Ravanfar, 2015). The analysis of these elements is conducted for the evaluation of the extent to which they are aligned to the organization and its objectives. The main aim of the clinic, in this case, is the provision of quality healthcare.
Strategy refers to a scheme structured by an organization for the achievement of a sustained competitive advantage and is successfully competitive (Ravanfar, 2015). An effective strategy is one that is clearly defined and supported by a strong vision, mission and values. On the other hand, the structure is a representation of the way the divisions of the firm are structured while including information on the accountability of different stakeholders. It can also be referred to as the organizational chart of the firm.
A system is a procedure within a firm that reflects the day to day activities that occur and the decision-making process involved. They are the section of the firm which determine how business is conducted and act the core area of focus for the management of the firm (Channonn & Caldart, 2015). The capabilities of the staff of an organization are referred to as skills. They also involve their competencies and expertise. At the time of change, the central area of assessment is the skills that require to undergo reinforcement.
The staff element refers to what type and the form of employees that a firm will require. It also includes all human resources activities such as the recruitment, training, motivation and reward of the workers. Style is a representation of how the management of an organization is conducted by top-level management, the ways in which they interact and its value. It involves the assessment of the management style of the leaders with an organization. The last element is shared values refers to the norms and standards which direct the behaviour of employees with an organization (Ravanfar, 2015). These shared values also dictate the activities within a company. This change model is highly appropriate for the situation as all these elements contribute to the culture of the organization. An assessment of each element enables the facilitation of comprehensive changes to the culture of the organization.
Proposed Plan
Based on McKinsey 7-s model, the plan below has been structured to be used by the Master's prepared nurse to improve the situation;
Identification communication components that have adequate alignment
This step of the plan will involve an assessment of each element of the hospital to understand whether they are appropriately aligned with each other. This means identifying any gaps or inconsistencies that may exist in each element (Schafua, Sandau, & Diedrick, 2013.. In this case, the master’s prepared nurse should assess all elements with a prioritization of the elements of shared values and how the organizational norms are linked to the delivery of quality healthcare.
Determining the optimal organizational design
With the help of some members of top management, the master's prepared nurse can find out the effective corporate model that is necessary for improving communication. The nurse will need to identify the best way systems can be aligned, which will require the collection of data. Hence, this will require a proper understanding of the organization, its environment and the characteristics of its employees (Schafau et al., 2013). This will help in identifying the best design that suits the enhancement of communication in the provision of services by patients to nurses.
Make a decision of specific areas in which changes can be made
This includes an action plan that details the areas that the nurse will see fit to realign and how the nurse would like to realign that. Upon an identification that of the structures of the firm and the management approaches are not well integrated with the organizational values, the nurse can then make a decision on relationships can be reformed (Grol, Wensing, Eccles, & Davis, 2013).
Discuss the need for change
Once all stakeholders within the hospital understand the need for change, they will be more prepared to take part in any corrective strategies or modifications to be implemented in the future (Grol et al., 2013). They will also have an understanding of the ways in which their actions affect the achievement of the clinic's objective.
Make the necessary changes
Within this step, the implementation of identified changes occurs. This means engaging all the information collected regarding the changes that have to be made and implementing the appropriate changes. This step will require the engagement of the necessary stakeholders.
Constant review of the 7s
The seven elements are in constant flux and undergo consistent shifts. A shift in one element always affects other existing elements while necessitating the implementation of a new organizational design. Hence, continuously reviewing each area is essential.
Strategies to Improve Communication
The practice of situational awareness and open communication
Situational awareness refers to being aware of what occurs in a unit for the assessment of any issues or concerns that may exist. Hence, encouraging staff collaboration will be necessary for supporting staff practices and the prevention of errors. This will enable the creation of a culture which promotes open communication between the team of nurses within the hospital along with the prevention of errors when communicating with patients.
Establishing purposeful rounding
Purposeful rounding is a systematic process used for the enhancement of the experiences of the patients through nurses proactively communicating with their patients. It enables the addressing of any uncertainties that patients are exposed to in healthcare contexts in which they cannot control their results (Ulanimo & Ligotti, 2011). Purposeful rounding will be critical to the support of anxious patients by setting an expectation for the experiences of the patients. With this strategy, the hospital can build the foundation upon which the management of the hospital promotes a culture of patient-centred care.
Training of nurses
Effective communication is essential to the quality of healthcare being provided. For effective communication to occur, nurses have to be aware of the existing strategies they can use to enhance communication (McGilton et al., 2017). One of the techniques that the nurses can be trained on is the patient teach-back technique. This is a technique in which nurses request patient to undertake the repetition of concepts, provide instructions or any other data in a way that the patient can understand. This is essential to assist the patient in the synthesis of the information. Hence, the training and education of nurses on such techniques would be critical in ensuring that the staff is well-equipped to communicate with the patients fully. Therefore, improving patient outcomes and the quality of healthcare.
Establishing metrics
Establishing measurements for patient-nurse communication will be significant in assessing the performance of nurses. By establishing metrics, each nurse will be aware of the effectiveness of their communicative abilities, while also gaining knowledge on how to make changes (Schafau et al., 2013). Hence, to assess nurse-patient communication, the metrics that can be used for assessment will include; explanation of things in ways patient can comprehend, and the treatment of patients with courtesy and respect.
Role of the Master’s Prepared Nurse as a Change Agent
Master's prepared nurses can act as change nurses within a hospital through the facilitation of collaboration and communication. This can be done by being leaders of interprofessional care teams, which provides them with the platform to enhance healthcare outcomes. A master's prepared nurse will ensure that all of their subordinates are adequately informed of proper issues and that they have an in-depth comprehension of the existing policies (Warren & Harper, 2017). Hence, a master's prepared nurse supports communication by ensuring that each member of their team is well-informed and has a proper understanding of any relevant issue that arises.
The master's prepared nurse will then be responsible for structuring plans on how collaborations can be conducted. This includes the assignment of duties to different nurses on the basis of their abilities and expertise. The nurse is also responsible for providing their subordinates with the proper tools that they require with the inclusion of training when needed. Through these actions, the nurse can ensure that there is an appropriate collaboration between the team members.
References
Channon, D. F., & Caldart, A. A. (2015). McKinsey 7S model. Wiley encyclopedia of management , 1-1.
Crawford, T., Candlin, S., & Roger, P. (2017). New perspectives on understanding cultural diversity in nurse–patient communication. Collegian , 24 (1), 63-69.
McGilton, K., Sorin‐Peters, R., Sidani, S., Rochon, E., Boscart, V., & Fox, M. (2011). Focus on communication: increasing the opportunity for successful staff–patient interactions. International Journal of Older People Nursing , 6 (1), 13-24.
Ravanfar, M. M. (2015). Analyzing Organizational Structure based on 7s model of McKinsey. Global Journal of Management And Business Research .
Schaffer, M. A., Sandau, K. E., & Diedrick, L. (2013). Evidence‐based practice models for organizational change: overview and practical applications. Journal of Advanced Nursing , 69 (5), 1197-1209.
Ulanimo, V., & Ligotti, N. (2011). Patient satisfaction and patient safety: outcomes of purposeful rounding. SAFETY , 11 (4).
Warren, J. I., & Harper, M. G. (2017). Transforming roles of nursing professional development practitioners. Journal for nurses in professional development , 33 (1), 2-12.
