The purpose of this project is to challenge the Rogosin Institute to implement staff teaching as part of its efforts to reduce the incidence of vascular access related infections. Some of the main objectives of the project is to underscore the importance of safety and the need for medical service providers to commit to continuous quality improvement. Serving thousands of patients every year, the Rogosin Institute is uniquely positioned to implement a change initiative designed to safeguard patient wellbeing. Additionally, the project hopes to drive down the number of infections that occur at the facility. In summary the min deliverables of the project are enhanced competence, lower incidence of vascular access related infections and a reduction in the risk of litigation resulting from malpractice and negligence cases. The high cost of litigation remains one of the key challenges that healthcare providers face today (Kass & Ross, 2016). This project holds the key to helping Rogosin Institute to tackle this problem.
The scope of the project is rather limited. It is only intended to equip the hospital’s staff with the skills, knowledge and perspectives that they need to prevent infections. The project is likely to encounter some constraints. If left unaddressed, challenges can frustrate the change implementation process (Dallas, 2015). To ensure that the project achieves its aims, there will be no exclusions. In fact, during the implementation, the project could be expanded to address new needs as and when they emerge. Some of the anticipated constraints include limited funding and lack of support from the hospital’s leadership. While these constraints are grave, they can be addressed through simple interventions. The preferred approach for implementing the education program involves combining traditional instruction with digital technologies.
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It is important for healthcare providers to ensure that change initiatives are aligned with their missions and visions. When this alignment is in place, it is much easier for the organizations to secure support and leverage its culture to implement the initiative successfully (Branson, 2008). There is no doubt that the entire project is aligned perfectly with the mission and vision of the Rogosin Institute. As noted above, this institute mission is to deliver high quality and compassionate care to its patients. By implementing the project, the facility will manage to limit the harm to which patients are exposed and demonstrate its commitment to patient wellbeing.
Organization Description
Located in Manhattan, NY, the Rogosin Institute is a healthcare provider with a commitment to patient wellbeing. This facility was established in 1983, and has successfully attended to the needs of thousands of patients. In the years it has been in operation, the Rogosin Institute has expanded the range of operations and achieved numerous milestones. For example, it has moved from a situation where hemodialysis and kidney transplants were regarded as novel procedures to its current state where it conducts these operations routinely. On a typical day, the Rogosin Institute attends to as many as 95 patients. This translates to over 27,000 patients annually. On its website, this institution states its mission as “To provide the highest quality, compassionate clinical care for people with kidney and other chronic diseases through a multifaceted, integrative approach” (“About Us”, n.d, par. 1). Through this mission statement, the facility assures its stakeholders, particularly patients, that it is dedicated to delivering high quality services. During the clinical experience at this facility, it was determined that its vision is to become the premier and preferred provider of services to patients ailing from kidney-related infections across the US. The proposed intervention will help the institution to accomplish both its mission and vision. By implementing this intervention, Rogosin Institute will succeed in enhancing patient safety and boosting practitioner competence.
Target Population
This project targets patients who are undergoing hemodialysis at the facility. The reason for focusing on this group is that it faces the greatest risk of acquiring vascular-access related infections. Evidence suggests that hemodialysis is a risky procedure and that vascular access related infections are worryingly prevalent (Allon & Sexton, 2018; Kumbar & Yee, 2019) In fact, the hospital has had dozens of cases of patients contracting these infections. The main need of these patients is being protected against infections. While undergoing hemodialysis, the patients are particularly vulnerable. If this vulnerability is not addressed, their health outcomes suffer. The target population makes up about 40% of the patients that the Rogosin Institute attends to.
Assumptions
For any change initiative to be successful, organizations must have adequate resources. A number of assumptions are made about the readiness and ability of the Rogosin Institute to implement the proposed solution. One, it is assumed that this institution has the financial resources to conduct staff teaching. Without finances, it is nearly impossible for any organization to effectively implement capital-intensive interventions. Two, an assumption is made that the Rogosin Institute’s top management is fully committed to the change initiative. For success in change initiative, strong and dedicated leadership is needed (Halkias et al., 2017). This assumption was confirmed during a visit to the Rogosin Institute. The facility’s senior leadership has repeatedly reiterated their understanding of the importance of leadership in change implementation.
Business Case
It is estimated that the implementation of the proposed solution will cost $30,000. As much as $25,000 of this amount will be spent in the implementation stage of the project cycle. During the planning stage, the facility will simply need to hold discussions and outline how the project will be implemented. Here, a total of $3,000 will be spent. Some of the specific tasks that will consume this amount include holding meetings, consulting with regulators and seeking the views of experts. Additionally, the organization will need to identify the factors that are crucial for the project to succeed and the issues that could cause failure. For example, the organization could establish that if the project does not receive employee endorsement, its success is difficult to guarantee. The actual implementation process will take the longest time (two weeks) and consume a bulk of the allocated budget. Securing the venue that will host the training sessions, hiring facilitators, persuading the employees to participate in the training, obtaining such material as publications and computers that will aid the training process and responding to unexpected delays are some of the specific activities that will be carried out during the implementation stage. At the closing stage, an estimated $2,000 will be spent in determining the impact of the solution. For instance, the Rogosin Institute may need to consult experts regarding the success of the project. Additionally, the company will review such data as project cost and seek stakeholder feedback to establish if the project was implemented successfully. Given that it is rather simple, this project is not capital intensive. Instead, it is labor intensive given that experts will be brought on board to educate the institution’s personnel. Provided below is a timeline of the various activities that will be carried out and the corresponding cost:
All the costs that Rogosin Institute will incur are aligned with the activities that will constitute the implementation process. For example, given that they are rather simple, the planning and closure stages cost the least amounts. At these phases, the organization will essentially engage experts with the goal of establishing the viability and success of the project. The activities carried out in the implementation phase will cost the highest amount. This is because these activities are rather capital intensive. For example, in procuring training equipment and material, the organization will incur huge costs. Therefore, the cost estimates are reasonable and aligned with the implementation activities.
Team Structure
The Rogosin Institute will need to ensure that all stakeholders are involved in the adoption of the staff teaching initiative. For initiatives to be implemented successfully, collaborative partnerships are needed (Bond-Barnard, Fletcher & Steyn, 2018). Among the stakeholders that will take part in the implementation process include senior leaders, nursing practitioners, physicians and education experts. Each of these parties will play a different role. For example, the leaders will provide general direction and ensure that the implementation occurs smoothly. On the other hand, the education experts will teach the institution’s staff. The different stakeholders will perform their respective roles within the Rogosin Institute premises. It is here that the project will be carried out. The nursing manager will serve as the overall project manager. This practitioner is properly placed to manage the project given her familiarity with the vascular access related infection problem and understanding of the needs of the institution.
Communication and Change Management Plan
The Rogosin Institute will need to establish proper communication approaches. These approaches will play a crucial role in facilitating the transfer of information among the various stakeholders. To generate interest in the solution, the nursing manager will be approached. During communication with the nurse manager, focus will be given to the promise that the proposed solution holds and the need for the hospital to move with speed in its implementation. In addition to establishing a communication framework, the Rogosin Institute must also develop a change management plan. This plan should follow the eight-step process outlined in the Kotter model. Among other things, this model challenges organizations to create a sense of urgency, build coalitions, celebrate progress and integrate the change initiative into their culture (Kotter, 2012). Rogosin Institute will follow all of the eight steps as it manages the change process.
Quality Plan
Rogosin must ensure that the staff teaching initiative achieves the desired outcomes. To do this, the organization needs to adopt a quality plan. During the implementation period, assessments of the practitioners will be used as the main tool for ensuring quality. The practitioners participating in the teaching will be required to share insights about the knowledge they have gathered and the competencies that they have developed. As part of follow-up, the hospital will need to examine changes in the number of vascular access related cases. A drop in these cases will suggest that the project has been successful.
Project Controls
Cost, practitioner feedback and patient experiences will serve as the primary project controls. Rogosin institute will need to closely monitor the costs to ensure that they do not exceed the budgeted $30,000. Additionally, the hospital should engage its practitioners to establish if they feel that the project has been successful. Another measure that the institution should adopt involves consulting patients regarding their experiences. Combined, these control measures will help the hospital to stay within the budget and timeline.
Summary
The significance of this project cannot be overstated. If implemented fully, it will lead to a significant decline in the prevalence of vascular access related infections at the Rogosin Institute. This organization simply must implement the solution. Should it fail to proceed with the implementation, it will be exposing its patients to serious danger. Additionally, failure could cause the hospital to be sued for negligence and malpractice. The implementation will also help the hospital to achieve its main goal of delivering high quality and safe care.
References
About us. (n.d). The Rogosin Institute. Retrieved October 8, 2019 from https://www.rogosin.org/about-us/
Allon, M., & Sexton, D. J. (2018). Tunneled, cuffed hemodialysis catheter-related bacteremia. Uptodate. Retrieved October 8, 2019 from https://www.uptodate.com/contents/tunneled-cuffed-hemodialysis-catheter-related-bacteremia
Bond-Barnard, T., Fletcher, L., & Steyn, H. (2018). Linking trust and collaboration in project teams to project management success. International Journal of Managing Projects in Business, 11 (2), 432-57.
Branson, C. (2008). Achieving organizational change through values alignment. Journal of Educational Administration, 46 (3), 376-95.
Dallas, J. H. (2015). Mastering the challenges of leading change: inspire the people and succeed where others fail. Hoboken, NJ: Wiley.
Halkias, D., Santora, J. C., Harkiolakis, N., & Thurman, P. W. (2017). Leadership and change management: a cross-cultural perspective. Milton Park: Taylor & Francis.
Kass, J. S., & Ross, R. V. (2016). Medical malpractice reform: historical approaches, alternative models, and communication and resolution programs. AMA Journal of Ethics. Retrieved October 23, 2019 from https://journalofethics.ama-assn.org/article/medical-malpractice-reform-historical-approaches-alternative-models-and-communication-and-resolution/2016-03
Kotter, J. P. (2012). Leading change. Brighton, MA: Harvard Business Press.
Kumbar, L., & Yee, J. (2019). Current concepts in hemodialysis vascular access infections. Advances in Chronic Kidney Disease, 26 (1), 16-22.
