Nursing

2

A Proposal for Establishment of an Outpatient Immunization Clinic

Terri Scruggs

Health Service Management internship

Capstone Project

11/28/2021

Vision: We will lead the region in exceptional patient experiences.

Mission: We will preserve and restore health, one person at a time.

Introduction

Baton Rouge General Medical Center was established in 1900 as the first full-service community hospital. Over the years, Baton Rouge General, hereafter referred to as BRG, has evolved into one of the key healthcare providers in Baton Rouge city. Over its long history, BRG has had numerous milestones. It was the first hospital to have a heart operation performed in the city, creating the first diabetes program and being the first hospital in Louisiana to establish a chemical dependency state ( Baton Rouge General, 2018).

These milestones undercut (did you mean undercut)? BRG's commitment to identifying ways to better the health of the Baton Rouge community through improving education, prevention, and ensuring timely access to quality healthcare. As of 2018, BRG had 588 licensed beds, 800 physicians from over 80 medical specialities and subspecialties, and over 3,500 employees, making it a regional leader in speciality programs and primary care.

Goals of the OIC

· Improve the health of the Baton Rouge Community by increasing access to preventive care.

· Cement BRG isas the overall leader in providing primary and secondary health care services in the Baton Rouge community.

Objectives of the OIC

· To vaccinate 10,000this may be over ambious so that is 192/week with ; 40/day and 5/hr people per year against immunizable diseases in Louisiana.

· To vaccinate 2,000 children each year against immunizable diseases, thus contributing to the overall reduction in infant mortality rates in Louisiana.

· To become a strategic immunization centre in the Baton Rouge Community and its surrounding environments.

Organizational Chart

Baton Rouge General Hospital Management

Chief Nursing Officer (Ms. Nijoka)

Director of Outpatient Service

Director OIC

Chief Resident Nurse

Nursing Practitioner

Immunization Coordinator

Front Desk Receptionist

Fig 1: An organizational chart of the proposed OIC

Chief Resident Nurse. The chief resident nurse will be responsible for coordinating the provision of healthcare services at the OIC. You do not indicate the degree of this person but will they have a more advanced degree over the nurse practitioner?

She will be pivotal in ensuring that patients receive quality services and address all customer complaints related to immunization services. As a nurse, they will have ample understanding of the procedures, processes and expected outcomes. Such an understanding is needed to help the clinic achieve its goals, objectives.

It is also a valuable set of knowledge in patient management and the overall success of the clinic. Further, understanding the issues other nurses and frontline health staff face will be important when addressing their concerns. The position is important as it ensures the overall efficiency of immunization services provided

Nursing Practitioner. Responsible for the administration of the immunizations. The position is important as it ensures that all immunizations carried out can be traced back to an individual for ease of accountability.

Front Desk Receptionist. Will be responsible for booking patients, welcoming them to the clinic, answering patient questions, and directing them. The position is crucial as it removes patients' confusion about not knowing where to start or what procedure to follow. It is also important in streamlining the efficiency and overall satisfaction of the patients.

Immunization Coordinator. Will be responsible for keeping track, recording, maintaining records and data about all immunizations carried out at the clinic. They will also liaise with the chief resident nurse to identify areas of improvement to ensure all immunization services are available. The position is crucial as it will enhance data collection, manipulation, and analyses for the overall effectiveness and efficiency of the clinic.

Justification

BRG is a primary care provider in Baton Rouge Community and Louisiana State University. At the core of BRG's drive is the need to preserve and restore the community's health one person at a time. Services cater to different health needs, including cancer, cardiovascular, and burns. BRG's OIC falls within the broader scope of efforts needed to achieve a healthy community.

The 2018 CHNA identifies that various factors, referred to as social determinants of health, can potentially influence the achievement of a healthy community. Key among them is the health care system in which health coverage and provider availability are significant factors. These two factors can negate efforts to promote a healthier community if they are not addressed. The state's infant mortality is among the highest in the country, standing at 5.4 deaths per 1000 births. Some of those deaths are avoidable if timely access to and immunizations are conducted (Pritchard et al., 2017). Need to make a stronger case e.g. statistics, data, reports

SWOT ANALYSIS

Strengths

1. An already well-established BRG management 2. Ample funding 3. Access to expert opinion from other BRG departments and affiliates 4. An assured client base 5. A supportive community and working environment

Weaknesses	1. Lack of prior experience in the running of OICs 2. Large primary area of service.
Opportunities Don’t confuse opportunities with strengths	1. No competing facility within the city 2. Assured client-base 3. A preceding reputation of services offered at BRG 4. A supportive network of health care providers in Baton Rouge City
Threats	1. High population primary within the primary and secondary service areas.I don’t understand this statement 2. Possible overutilization of the facility due to lack of other similar facilities within the city.

Job Description

BRG Outpatient Immunization Clinic

Chief Resident Nurse

Location: Baton Rouge Parish, Louisiana

Reports to the director Outpatient Immunization Clinic

November 18, 2021

OverviewGo back and review powerpoint on job descriptions

BRG Outpatient Immunization Clinic (OIC) is part of the BRG Hospital mandated with running the immunization operations.

As part of the wider BRG hospital, whose main mission is to improve the community's health, OIC is looking for a qualified person to fill the position of the chief resident nurse.

OIC promises to be a thriving and inspiring place of work with huge potential for career progression. Suppose you are a result-oriented individual geared towards promoting community health. In that case, it is you we are looking for, come and become part of the largest medical team in Louisiana.

Job Summary

The position of chief resident nurse performs numerous duties, among them management of overall service provision, handling of grievances, dispute resolution, situational analysis, and preparation of reports to the director OIC. Working together with the operations team under them, the chief operating nurse ensures the clinic's smooth and effective provision of immunization (NCIRD, 2021).

Responsibilities and Duties need to be more concise; bullets not numbers

i. Report to the director IOC on the status of the immunization services at the clinic daily, or any time such information may be requested.

ii. Prepare weekly reports to the director IOC on the clinic's status, including recommendations on improvement areas.

iii. Coordinate all health services at the clinic and report any issue to the director.

iv. Follow up on customer complaints and ensure that they are adequately addressed.

v. Perform regular monitoring of the immunization services and address any challenges faced by the operations team

vi. Receive complaints, suggestions, recommendations, and any other information from the operations team and address them appropriately in liaison with the director IOC.

Job Qualifications

-A degree in nursing science (BNS) or the equivalent from an accredited university

-At least a diploma in management with a focus on health care management

-A Master of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP) will be an added advantage.

-A minimum of 10 years as a nurse in a community hospital with at least two years in a management role.

-Proficiency with computer systems

-Excellent conflict management skills

-Great communication skills

-Understanding of HIPAA

-Ability to lead, manage and work with teams

BRG Outpatient Immunization Clinic

Front Desk Receptionist

Location: Baton Rouge Parish, Louisiana

Reports to the Chief Resident Nurse

November 18, 2021

Overview

BRG Outpatient Immunization Clinic (OIC) is part of the BRG Hospital mandated with running the immunization operations. As part of the wider BRG hospital, whose main mission is to improve the community's health, OIC is looking for a qualified person to fill the front desk receptionist position. OIC promises to be a thriving and inspiring place of work with huge potential for career progression. If you have excellent communication skills, the ability to perform exceptionally well under pressure, and the ability to multitask, OIC is looking for you. Come and be part of the team changing the health landscape of Baton Rouge City.

Job Summary

The position of front desktop receptionist performs the duties of attending to patients on the phone, in person, answering patient inquiries, directing enquires appropriately, coordinating bookings, organizing the clinic's waiting bay, registering patients into the system, and carrying any other task that promotes a smooth healthcare environment at the clinic to promote a quality patient experience.

Responsibilities and Duties

i. Ensure a smooth flow of patients in and out of the clinic

ii. Direct patients based on their needs at the clinic

iii. Answer and assist patients with questions regarding procedures at the clinic

iv. Book patients into the hospital system and ensure all their details are properly captured.

v. Coordinate with other clinic staff to ensure a satisfying environment for patients in the clinic

vi. Answer incoming calls and transfer calls as required.

vii. Inform patient of immunization clinic procedures

viii. Assist patients in completing any necessary documentation.

ix. Greet patients

Job Qualifications- use behvior verbs

-A diploma or higher in customer relations management

-At least five years of experience working at the front desk with a minimum of one year in the healthcare setting.

- Computer proficiency

-Ample understanding of hospital systems

- Basic knowledge of medical procedures and terminologies

-Excellent conflict management skills

-Great communication skills

-Understanding of HIPAA

-Ability to work within a team

Interview Questions

a. Chief Resident Nurse

i. BRG's mission seeks to preserve and restore the health of individuals one by one. As the person responsible for providing immunization services, how do you intend to use this position to ensure BRG's lives to its mission?

ii. One of the key drivers of health inequality is social health determinants that limit access to health care. With a population diverse as that of Baton Rouge Parish, the primary service area of BRG and IOC, how do you intend would you; have not hired them yet! to address complaints from patients related to social inequities, including racing?

b. Front Desk Receptionist

i. As the face of the clinic, how dowould you intend to use your position to promote the clinic and BRG as the leaders in providing primary care in Baton Rouge City?

ii. How would you handle a situation where there are several patients all asking for your attention with some shouting and already showing some level of impatience?

Data Collection and Assessment

After successful implementation of any project, of which OIC falls categorically as a project, data collection methods to assess the success of the project and the extent to which pre-established objectives have been achieved should be identified. To assess the success of the OIC concerning achieving the earlier identified objectives, data will be collected through the following methods:

a. Patient records. Patient records will form a crucial key data source to determine whether the key objectives have been achieved.

b. Patient records provide key information, including age, type of healthcare service received, and the number of persons who have received the particular service for the duration under review. This addresses the first and maybe second objective but be more specific—relate to the objective.

c. Questionnaire. A question containing several questions regarding the quality service, availability, and success of receiving service will be sent to random patients at the end of the duration under review. The responses obtained from the questionnaire will be analyzed statistically to obtain crucial information about the success of the OIC and how well the set objectives were achieved.

d. Surveillance. This involves real-time monitoring and collection of relevant data continually. Surveillance is crucial as it helps track the project's progress daily, which is crucial in ensuring that the set long-term objectives have been achieved. In the context of OIC, real-time data to be collected include information on the number of patients per day, the number of complaints filed regarding service unavailability, customer requests for OIC services, age groups of patients served, complaints, and inquiries. The information obtained will be crucial in monitoring the various key performance indicators established to assess the achievement of the set objectives. How will this measure objective #3?

Growth Opportunities

BRG continues to seek to be a sustainable community healthcare provider. As observed in the 2018 CHNA report with the closure of Earl K. Long Medical Center, hospital closures significantly impact the communities around them.

However, one of the main effects is the overburdening of the remaining healthcare providers leading to a possible overwhelming state healthcare system. Considering this, the establishment of OIC observes several growth opportunities that are key to its sustainability.

· Under-served population. The 2018 CHNA reports identify that Baton Rouge City has diverse population composition. With this composition, the inherent society inequities in income, education, and housing significantly contributed to health inequities even with residents living within close zip codes. The result is under-served people in Baton Rouge City who have limited access to the health care system. Thus, a great growth opportunity is to focus on bringing accessibility to these community members by opening satellite OICs in these under-served communities.Good!

· Huge service area. BRG's primary service area encompassing Easton Baton Rouge, Livingston, Ascension Parishes have a significant total area with a total population of 696,350 residents. Combined with the secondary service areas, which have a total population of 276, 739 residents, BRG already has a sizeable client base for its operations. As part of BRG, OIC will also serve this client base which thus presents a significant growth opportunity. Further, given that this clinic will be among the very few immunization clinics in Louisiana; thus, the prospect of growth is huge.I am not sure how this is different from the first growth opportunity

References

Community Health Needs Assessment | Baton Rouge General Hospital. Baton Rouge General. (2018). Retrieved June 21 2021, from https://www.brgeneral.org/documents/content/2018_CHNA_with_web_version_8-28-18.pdf.

National Center for Immunization and Respiratory Diseases. (2021). General recommendations on immunization---recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports, 60(2), 1-64.

Pritchard, J. M., Kennedy, C. C., Karampatos, S., Ioannidis, G., Misiaszek, B., Marr, S., ... & Papaioannou, A. (2017). Measuring frailty in clinical practises a comparison of physical frailty assessment methods in a geriatric out-patient clinic. BMC geriatrics,error 17(1), 1-8.