Tag Archives: organizations

WHAT ARE THE POTENTIAL CHALLENGES OR BARRIERS TO IMPLEMENTING NURSE LED TRIAGE IN OTHER HEALTHCARE ORGANIZATIONS

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Change management and buy-in from stakeholders will be crucial for successful implementation of nurse-led triage. Getting physicians, administrators, nurses and other staff on board and supportive of the transition to this new model will require effective communication of how it will benefit patients and the organization. Physicians may be resistant to ceding some of their traditional decision-making authority over patient care. It will need to be demonstrated that advanced practice nurses and NPs have the clinical expertise and competency to conduct triage safely. Administrators will need to see it can help maximize staff utilization and potentially reduce wait times and left without being seen rates. Nurses taking on this new role may feel anxious about expanding their scope of practice. Comprehensive training programs and leadership support will be important to gain confidence and buy-in.

Sufficient nursing resources and the ability to flex staffing patterns to meet fluctuating demand will also pose a challenge. Nurse-led triage requires nursing FTEs be dedicated to conducting medical screening exams, ordering tests, and determining the proper treatment stream or disposition rather than splitting time between multiple tasks. Having backup nurses available during peak volumes or implementation will ensure triage can still be performed timely when volume temporarily exceeds staffed positions. Tools to accurately forecast patient volumes and develop flexible staffing schedules will need to be utilized. Organizations with nursing shortages or inflexible scheduling may struggle to consistently meet these resource needs.

Ensuring the competency and ongoing development of nurses and NPs transitioning or newly hired into triage roles will take ongoing investment. Advanced assessment and diagnostic reasoning skills differ from general floor nursing. Formal didactic and clinical training programs will need to be developed and/or augmented with competency validation. Opportunities for continued education and skills practice must also be provided. Without maintaining a high level of competency it can compromise patient safety and outcomes if the wrong dispositions are made. Role expansion may also increase nurse turnover if adequate training and career ladder opportunities are not available.

Workflow redesign and upgrades to technologies like the EHR will be needed to fully support nurse-led triage. Existing paper or basic electronic systems may need reconfiguring to capture the level of documentation and decision making required in triage. Order sets, protocols, and determinant tools may need building/customizing. Changes to how patients physically flow through the department may also be needed. Without the proper tools and workflows in place, triage nurses could become frustrated and inefficient. Delays treating the right patients in the right areas and duplicative testing could negate purported benefits.

Legal and regulatory issues surrounding the scopes of RN and NP practice will need to be thoroughly evaluated and addressed on a state by state basis. While most nursing programs train to an advanced level, state boards set the scope parameters and some may prohibit independent decision making. Organizations would likely need to engage in discussions with these regulatory bodies to gain comfort that aspects of triage like selecting treatment streams fall within legal scopes. Medical malpractice insurers may also need to vet coverage of nurses in these expanded roles. Without resolved legal and regulatory clarity up front, implementation timelines could face delays or need to be scaled back in certain locations.

Cost is another potential barrier depending on factors like the need for capital equipment, renovations, training programs, additional staffing, and information system modifications. A business case would need to evaluate both the hard costs of implementation and ongoing operations against projected utilization, revenue generation from increased volumes, reduction in wait times, and other quality improvements. The payback period may stretch beyond standard capital allocation timeframes in some environments depending on the baseline utilization and financials. Without a clear return on investment demonstrated, gaining administrative and financial approval could prove difficult especially if competing against other strategic priorities with perhaps faster paybacks.

Change management, sufficient resources, competency development, workflow and technology optimization, legal and regulatory alignment, and a strong financial case will all need thorough planning and mitigation to reduce barriers to successful nurse-led triage adoption. A phased, multi-year approach may smooth the transition by piloting in certain areas, upskilling staff gradually, and incrementally expanding the model. Leadership support, cross-functional participation, and ongoing evaluation will also help address issues that arise proactively rather than letting them become insurmountable roadblocks. With diligent preparation to overcome these challenges, nurse-led triage has great potential to provide higher quality, more efficient care delivery.

HOW CAN ORGANIZATIONS MEASURE THE SUCCESS OF THEIR DIVERSITY EQUITY AND INCLUSION INITIATIVES

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There are several key ways that organizations can measure the success of their diversity, equity, and inclusion (DEI) initiatives. It is important to develop meaningful metrics and track both qualitative and quantitative data over time to assess progress and the impact of DEI efforts.

Retention and representation metrics: Tracking retention rates and representation data across different demographic groups can help measure success. Organizations should look at things like retention of minority employees, women, people with disabilities, and other underrepresented groups compared to overall retention rates. They can also track representation rates in leadership, different levels of management, overall workforce composition, recruiting pipelines, and retention from recruiting to hiring. Increasing retention and improving representation over time across all groups would indicate positive impact from DEI initiatives.

Employee experience through surveys: Conducting anonymous surveys that measure employee experience related to DEI can provide valuable insight. Questions can assess how included and welcomed different groups feel, their sense of belonging, fair treatment, and whether the culture is improving. Benchmarking survey data over multiple years shows trends. Response rates from underrepresented groups are also important to track, as are actions taken in response to survey findings. Continuous improvement in employee feedback would suggest DEI efforts are enhancing workplace experiences and culture.

Engagement and satisfaction metrics: Tracking metrics like employee engagement scores, satisfaction rates, “likelihood to recommend employer” scores, broken down by demographic group, can gauge impact. DEI initiatives aim to enhance all employee experiences, so engagement and satisfaction rates improving or remaining high among all groups is a sign of progress. Surveying people who recently left the company on their experiences can also highlight areas for improvement.

Progress on DEI goals: Setting public, measurable DEI goals is important for accountability. Tracking progress made on specific, time-bound goals shows if initiatives are effective. For example, goals may include doubling the number of women or minorities in leadership by a certain date, mandating DEI training completion rates, increasing spending with minority-owned vendors, etc. Evaluating progress on concrete, transparent goals holds an organization responsible for following through on its commitments.

Diversity of opportunities: Tracking the diversity of employees accessing high-potential opportunities, like leadership training programs, coveted assignments, promotions, mentorship opportunities, can demonstrate impact. DEI aims to foster an inclusive environment with equal access to career-boosting opportunities. Seeing more equal representation of diverse groups accessing high-potential opportunities indicates the organization is culturally evolving.

Reduced bias complaints: Tracking formal and informal complaints related to bias, discrimination, unfair treatment based on personal attributes can provide useful metrics. A decreasing trend in such complaints over time suggests cultural shifts are occurring and DEI efforts are having positive effects. This also protects the organization by reducing legal risks.

Volunteerism and resource group participation: Tracking volunteer rates and involvement in employee resource groups (ERGs) by different employee demographic categories shows engagement. Representation in ERGs and rates of participation in volunteering suggests employees feel invested and supported enough to actively contribute back to DEI initiatives.

Supplier and vendor diversity: Tracking spending statistics with minority-owned, women-owned, veteran-owned businesses, etc. and increases over time demonstrate initiative follow through. DEI aims to promote inclusive and equitable hiring, sourcing, and procurement practices throughout business ecosystems.

Qualitative testimony: Soliciting individual employee stories of how the culture and their experiences have positively changed thanks to DEI efforts provides meaningful, credible qualitative metrics. Hearing diverse voices brings data to life and highlights the true impact initiatives have on workplace inclusion, sense of belonging, and empowerment.

By comprehensively tracking both quantitative and qualitative metrics across these and other impact areas, organizations can holistically gauge success, continuously improve efforts, and ensure accountability. Seeing steady, sustained progress in DEI metrics over multiple years indicates initiatives are driving meaningful, long-term cultural evolution.

WHAT ARE SOME RESOURCES OR ORGANIZATIONS THAT CAN HELP ME WITH MY CAPSTONE PROJECT IN CANCER CARE

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The American Cancer Society is one of the largest and most well-known cancer organizations in the United States. They have a variety of resources on their website that could aid in research for a capstone project. Some specific resources offered by the ACS include access to cancer facts and statistics reports, clinical care guidelines and protocols, information on emerging cancer treatment and technologies, data on disparities, survivorship care plans, and public policy initiatives and advocacy efforts. They also have a library of scientific research papers and journals. The ACS has numerous regional and local divisions across the country that may be able to provide local data, connect you with healthcare professionals, or give guidance on developing cancer initiatives specific to a given region or community. Reaching out to local ACS leadership could help identify potential mentors, interview subjects, or areas of need to focus a capstone project on.

The National Cancer Institute (NCI) is part of the National Institutes of Health and is the primary federal agency responsible for cancer research. The NCI is an invaluable resource for any capstone project involving cancer care research. Their main website contains a comprehensive cancer research database of over 1.5 million scientific citations and abstracts on cancer topics that can help with background research. They also publish extensive data and statistics reports on incidence, trends, mortality and survival. Beyond published research, the NCI has programs, task forces and initiatives focused on specific cancer types, disparities, survivorship and more. Connecting with program staff could shine light on emerging issues, challenges or opportunities within cancer care to build a capstone around. For projects involving human subjects research, the NCI also oversees a large clinical trials system that may allow connecting with patient populations.

State and local health departments maintain invaluable health data and are invested in improving cancer outcomes within their jurisdiction. Reaching out to chronic disease directors, cancer control coalitions or cancer registry staff at health departments could uncover local priorities, initiatives or gaps in screening, treatment or supportive services programming that are ripe for capstone exploration and analysis. They may also have cancer burden reports, or be able to provide microdata to examine geographic, racial or socioeconomic disparities that influence cancer experiences and outcomes within a state or community. Some states/regions have cancer plans that outline goals and strategies providing direction for potential capstone work.

Cancer centers, oncology practices and hospitals conduct pioneering research and deliver the bulk of cancer care. Reach out to nurse educators, navigators, social workers or other staff about current challenges, opportunities or pilot programs to evaluate. Clinicians may also be interested project advisors, and centers maintain biospecimen banks and patient registries generating robust data for analysis. Community clinical partnerships could advance understanding of how integrated models address social determinants of health, survivorship care coordination or other important practice and policy considerations.

National or local philanthropic cancer foundations fund research, provide patient support services and advocate for cancer patients. Foundations like the V Foundation, Lance Armstrong Foundation and Cancer Support Community could offer guidance on emerging issues, introduce contacts within their networks, provide data on their program impacts, or connect students to patient advisor roles. Leveraging foundation priorities and existing partnerships could help ensure capstone relevance and potential for translation into future practice.

With such a breadth of options, identifying the specific issues or populations of interest will help narrow the focus and determine the individuals and organizations most suited to aid in moving the capstone project forward. Reaching out with clear project goals and desired contributions in mind will help establish mutually beneficial collaborations. The end result would be robust research, practical applications and valuable experiential learning to enhance cancer care.

WHAT ARE SOME KEY CONSIDERATIONS FOR HEALTHCARE ADMINISTRATORS WHEN IMPLEMENTING NEW TECHNOLOGIES IN HEALTHCARE ORGANIZATIONS

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Technology adoption requires substantial investment of both financial and human resources. Administrators need to do a thorough assessment of the total cost of ownership which includes direct technology costs as well as training, implementation, support and maintenance costs over the lifespan of the technology. Return on investment calculations involving factors like increases in productivity, reductions in medical errors or lower costs of care delivery need to demonstrate that the technology will generate savings or value that outweigh the costs within a reasonably short time period.

The technology must address clear needs and generate demonstrable improvements in key areas like quality, safety, access or experience to justify disrupting existing workflows and processes. Prior to implementation, administrators must work with clinical and support staff to understand current pain points, opportunities for enhancement and priorities for technology solutions. Developing a business case focused on priorities linked to strategic goals helps gain stakeholder buy-in and support for changes.

Compatibility with existing infrastructure is a major technical consideration. New technologies need to integrate with the electronic health records (EHR) system, medical devices, lab systems and other critical applications already in use. Data standards and interoperability abilities determine how well a new solution will exchange information with current IT environment. This impacts downstream processes and reporting. Legacy issues, integration costs and reliability of interfaces must be evaluated upfront.

Regulatory compliance is another significant challenge for healthcare technologies due to the sensitive nature of patient data involved and legal/ethical requirements in the industry. Administrators have to ensure any new solution meets prevailing privacy, security and safety standards. This involves assessing the technology vendor’s maturity, certifications, previous compliance track record, ongoing patching capabilities, disaster recovery measures, etc. Lack of compliance can impacts reimbursements and accreditation of the organization.

Change management is vital but often underestimated while planning technology deployments in healthcare. Resistance to change is common due to Fear of new technologies, learning curves and disruption of familiar routines. To aid adoption, a structured communication plan and customized end user training strategy must address different learner needs, build confidence and champion early technology leaders. Adequate hands-on support from super users/clinical champions during and after go-live helps overcome adoption barriers.

Vendors need thorough evaluation based on their experience supporting clients of similar size, complexity and priorities. Beyond price, factors like product usability, support response time, upgrade policies, customer satisfaction ratings, security practices, customization abilities and breadth of modules/integrations need scrutiny. Long-term roadmaps allowing flexible, phased implementations aligning with evolving organizational needs are important too. Contract negotiations must address issues around data ownership, exit strategies, service level agreements, etc. to mitigate future risks.

It is also critical to establish governance structures, change control processes and metrics for ongoing monitoring, course corrections and optimization. This helps improve functionalities based on collected insights and feed learnings back into further advancements. Periodic audits ensure technologies mature as per strategic goals and regulatory environment. As healthcare delivery models evolve rapidly, emerging technologies provide both challenges and opportunities. But planned, focused deployments maximizing value are key to success.

Evaluating total costs, impacts, need-fit, technical compatibility, compliance, stakeholder support and change readiness, vendor assessment and ongoing governance helps healthcare administrators to ensure implementation and scaling of new technologies in a responsible manner aligned with their organizations’ mission and priorities. While technology promises benefits, thoughtfully incorporating human factors like workflows, responsibilities and learning ensures successful, sustainable deployments and enhances the overall quality and safety of care.

HOW CAN ORGANIZATIONS MEASURE THE EFFECTIVENESS OF DISTRIBUTED LEADERSHIP IN THEIR TEAMS

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Distributed leadership aims to share power and decision making responsibilities across multiple individuals rather than centering authority in a single leader. For distributed leadership to be effective, there needs to be coordination and collaboration between team members. Organizations can measure the effectiveness of distributed leadership in their teams through both qualitative and quantitative measures.

Qualitative measures provide insights into processes, perceptions, and relationships within the team. Some qualitative methods organizations can use include interviews, focus groups, observations, and surveys. Interviews with team members can uncover their perceptions of shared leadership, involvement in decisions, collaboration, effectiveness of coordination, levels of empowerment and buy-in to distributed leadership. Focus groups bring team members together to discuss similar topics in a group setting and can elicit richer discussion. Observational data from team meetings and interactions provides insights into real-time coordination, involvement of various members, and decision making dynamics. Surveys with questions on a scale can gauge agreement with statements about shared power, collaborative culture, accountability, and goal alignment.

In addition to qualitative measures, organizations should also track quantitative metrics that indicate the outputs and outcomes of distributed leadership. Key performance indicators (KPIs) related to the team’s goals provide objective measures of effectiveness. Output metrics may include numbers of ideas generated, problems solved, projects completed on time, and tasks accomplished. Outcome metrics assess the impact on broader business objectives such as customer satisfaction scores, revenue growth, quality improvements, cost reductions, innovation levels, and other strategic targets set for the team. Tracking these metrics over time shows whether performance is increasing with distributed leadership or if adjustments are needed.

Comparing quantitative results to qualitative perceptions also provides a more holistic view. For example, high customer satisfaction surveys could be aligned with strong qualitative agreement that the team works collaboratively to understand and resolve customer needs. Discrepancies between the two types of measures may indicate underlying issues. Low quantitative performance despite positive qualitative views would suggest a need to refocus collaborative efforts.

Other signs that distributed leadership is working effectively include high levels of employee engagement, motivation, and collaboration reported through surveys. Turnover rates and retention data provide insights into how empowered and invested team members feel. Diversity of perspectives and open exchange of ideas in meetings, as observed or reported, demonstrate involvement and input from across the group rather than a few dominant voices.

Organizations should also track qualitative and quantitative measures over long periods to account for change over time as distributed leadership evolves. Regular reviews of results can identify what is going well and adjustments that may be warranted to continuously improve the model. Bringing both leaders and employees together to jointly analyze and discuss the findings fosters transparency, accountability and collaborative solutions. With a multidimensional approach focusing on both outputs and outcomes through a mix of objective metrics and subjective perceptions, organizations can gain a comprehensive view into how distributed leadership is enhancing team effectiveness. Regular measurement ensures the approach remains on track to deliver ongoing benefits or indicates where mid-course corrections may be needed.

To effectively measure the impact of distributed leadership, organizations should gather both qualitative and quantitative data through various methods. Qualitative data provides insights into processes and perceptions, while quantitative metrics track outputs and outcomes related to goals and objectives. Comparing the results of different measures over time reveals trends and discrepancies to guide continuous improvement. Regular measurement and collaborative analysis keeps distributed leadership models accountable while fostering involvement, transparency and empowerment across teams.