After an evaluation of the processes, operations and structures of Mercy Medical Center, it was determined that there are areas that are in urgent need of improvement. The long working hours and the high readmission rates are among these areas. Further, it was determined that by addressing the issue of the long working hours, the hospital would vastly improve the quality of care. It is recommended that in a bid to reduce the long working hours, Mercy Medical Center should restructure its working schedule. As it does this, the provider will be safeguarding the wellbeing of its staff thereby enhancing patient outcomes.
The Need for Change
There are a number of reasons why Mercy Medical Center needs to implement the change introduced above. That the change holds the key to promoting staff satisfaction and wellbeing is among this. Research findings show that when they are allowed to work for fewer hours and offered such benefits as time-off and regular breaks, medical practitioners witness improvements in their satisfaction levels (Jaafarpour & Khani, 2012). Moreover, schedules that prioritize practitioner wellbeing allow the practitioners to avoid such issues as fatigue which could have detrimental impacts on their productivity. The need to safeguard patient wellbeing is another issue that warrants the adoption of change. Shorter work hours for nurses and other medical practitioners have been associated with improved patient outcomes (Patterson et al., 2018). By allowing its practitioners to work less hours, Mercy Medical Center will set the stage for enhanced quality of care.
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Recommended Strategies
As part of its adoption of the change proposed above, Mercy Medical Center should implement a number of strategies. One of the strategies is capping the maximum working hours at 12. Through the implementation of this strategy, the hospital will shield its practitioners against such issues as fatigue and medical errors. Another strategy that the hospital should pursue is allowing its practitioners time off after long shifts. For example, after working three consecutive 12-hours shifts, practitioners should be allowed a day off. Adopting a policy that allows practitioners to use their professional judgment to determine if they are able to work overtime is another strategy that the hospital should implement. This strategy promises to empower the practitioners and safeguard patient wellbeing.
The strategies recommended above are drawn from evidence-based literature and their implementation will allow the hospital to comply with relevant laws while ensuring cultural sensitivity and inclusiveness. For example, in their article, Stimpfel, Sloane and Aiken (2012) contend that placing a limit on working hours and allowing nurses to have a voice in how schedules are developed goes a long way in preventing burnout and promoting patient satisfaction. As already stated, the implementation of the strategies above will place the hospital in compliance with laws. For example, the Fair Labor Standards Act stipulates that firms should offer their employees overtime pay when they work for more than 40 hours in a week (DOL, n.d). The Patient Protection and Affordable Care Act is another law with which the hospital will be complying when it implements the strategies above. One of the key provisions of this law is that providers should strive to provide care of high quality. Through the strategies above, Mercy Medical Center will be successful in safeguarding the wellbeing of its patients.
As it implements the recommended strategies, Mercy Medical Center should be wary of knowledge gaps and uncertainties that could hamper the implementation process. It could be that the hospital has not had to implement such a policy in the past. If this is the case, the hospital may be unable to anticipate and prepare for any challenges arising from the implementation process. For example, as it reduces the number of working hours, the hospital may be unable to attend to the same number of patients as it has historically done. How does it help the patients that its practitioners are unable to attend to? Another uncertainty that the hospital should brace for concerns the cost of implementation. As already noted, the implementation may require the hospital to hire more practitioners. It is difficult to establish the cost of this exercise with certainty.
Potential Effects of Environmental Factors
As it implements the strategies above, Mercy Medical Center should understand that federal, state and local regulatory and legal frameworks will shape the implementation process. In general, these frameworks will encourage the hospital to remain committed to the implementation process. For example, the firm could draw inspiration from the Fair Labor Standards Act’s requirement that firms should offer overtime pay. The threat of penalty for violating the laws will particularly motivate the hospital to follow the laws. Apart from the laws, organizational issues such as funding, staffing and support services will also shape the implementation process. For example, to reduce the working hours, Mercy Medical Center may need to hire more practitioners and this is a resource-intensive undertaking. For the strategies to be implemented effectively, the hospital needs adequate financial resources. The strategies above are indeed realistic because they are practical and in line with Mercy Medical Center’s record of excellence.
In the discussion above, some of the environmental factors that may influence the implementation process have been identified. This discussion is not exhaustive since there are other factors that will have significant impacts on how the hospital implements the recommendations. Patient volume, staff shortages and absences are among these factors. Mercy Medical Center treats thousands of patients. As it limits the number of working hours, it can be expected that there are patients whose needs will go unmet. The hospital may need to implement the changes gradually so as to minimize the harm that patients suffer. If the implementation is conducted drastically, patients will bear the brunt. Staff shortages and absences are other factors that will shape the implementation process. Already, the hospital is short-staffed. This is why practitioners are working long hours. The shortage threatens to derail the implementation process. The process could be derailed further by unexpected absences. For full and effective implementation, Mercy Medical Center requires the involvement of all staff.
Policy, Guidelines and Stakeholders
In implementing the recommended strategies, Mercy Medical Center needs to be governed by a policy and guidelines. The following is the policy: In a bid to improve patient wellbeing and the satisfaction levels of its stakeholders, Mercy Medical Center commits to adopt fairer labor practices.” Accompanying this policy are the following guidelines:
The hospital places the maximum number of hours that employees are required to work at 12.
If an employee feels able to work for longer hours, they should consult the management.
For all hours beyond the maximum 12, employee shall be entitled to overtime pay.
Employees will be consulted for any reviews of the policy on working hours.
The involvement of all concerned stakeholders is needed for Mercy Medical Center to be successful. Since they are the primary parties in the question of working hours, nurses, physicians and other employees will be closely involved in the implementation process. It is important to involve these stakeholders because their support is vital for success. Other stakeholders who should participate in the implementation process are regulators. The regulators are important because they will provide guidance on how the hospital can implement the policies within the confines of the law and applicable regulations. The fact that the implementation process leverages the support and resources of different stakeholders makes the recommended strategies both practical and realistic. Overall, as it engages all stakeholders, Mercy Medical Center will be able to improve its healthcare delivery processes.
The mere involvement of the stakeholders identified above is not sufficient for the successful implementation of the proposal. To demonstrate their commitment to the implementation process, the stakeholders need to embrace collaboration. Through collaboration, they will combine their resources and expertise to ensure that the proposals are effected properly. While collaboration among all stakeholders is important, it is particularly vital for the practitioners to work closely with the top leadership. The collaboration among these stakeholders is needed to resolve any differences or conflicts. For instance, the leadership may raise concerns that the implementation process is too costly. To address these concerns, the practitioners may express a willingness to make sacrifices such as working long hours during the initial phase of the implementation process. The leadership of Mercy Medical Center will need to be closely involved in the implementation because it has a number of important functions to perform. Providing overall direction, ensuring that all the required resources are available and responding to emerging issues are some of these functions.
References
Jaafarpour, M., & Khani, A. (2012). Evaluation of the nurses’ job satisfaction and its association with their moral sensitivities and well-being. Journal of Clinical & Diagnostic Research, 6 (10), 1761-4. DOI: 10.7860/JCDR/2012/4068.2638
Patterson, P. D., Runyon, M. S., Higgins, S. J., Weaver, M. D., Teasley, E. M., & Kroemer, A. J. (2018). Shorter versus longer shift durations to mitigate fatigue and fatigue-related risks in emergency medical services personnel and related shift workers: a systematic review. Prehospital Emergency Care, 22 (sup1), 28-36.
Stimpfel, A. W., Sloane, D. M., & Aiken, L. H. (2012). The longer the shifts for hospital nurses, the higher the levels of burnout and patient dissatisfaction. Health Affairs (Millwood), 31 (11), 2501-9.
United States Department of Labor (DOL). (n.d). Overtime pay. Retrieved October 6, 2018 from https://www.dol.gov/whd/overtime_pay.htm
