Evidence of the Need to Mitigate the Negative Impact of One Challenge

Running Head: ORGANIZATIONAL CHALLENGES 2

Synthesis of Evidence Sustaining Organizational Challenges

Letrese A. Lofton

Capella University

NHS 8051-Preparing for the Professional Doctorate in Public Health Administration

August 2021

The Naval Medical Center San Diego

The healthcare facility holds military population only and it provides more than one hundred specialty and subspecialty care services to the named population. In Western United States, it is perceived as the largest military healthcare facility with the most qualified staffs like the physicians and specialists across the world. NMCSD goal involves offering quality, compassionate and individualized services that each patient deserves. It’s services entails nine basic care units for the family members and eight medical clinics which provides services to active duty personnel (Vicente et al., 2020). The major healthcare services include admissions, adult ICU, mental health services, anesthesia, breast clinic including cariology. Also, CT surgery, dermatology, diabetes programs, dysplasia, endocrinology including every crucial services that are found in most healthcare facilities.

The Challenges that NMCSD Faces

The healthcare center has had issues with managing the inefficiencies in the command approval procedures for exhibiting the negative influence of DoD Graduate Medical Education. Which has in turn failed to meet the capability of ACGME scholarly event requirements (Valdez et al., 2018). That is why NMCSD has encouraged the staffs to meet ACGME requirements to trigger a Lean Six Sigma Rapid Improvement Event project. To analyze this challenge, they used two primary metrics and the first one involves the number of authored works submissions entailing all needed signatures and secondly the consumer satisfaction with the authored works procedure.

The basic metric baseline was collected using a clinical investigation data while tracking the publications and presentations. The secondary metric baseline was also gathered through a client satisfaction survey to GME faculty and residents. The findings revealed that the number of authored works with all the requirements improved drastically from 52% to 100%. Whereas the customer satisfaction came out as “completely and most satisfied.” in the questionnaires feedback which also improved from 24% to 98%. It is evident that for both results, signature compliance and customer satisfaction was well achieved with good percentage (Valdez et al., 2018). It is crucial to conclude that RIE project used LSS technique and instruments to enhance signature compliance and promote customer satisfaction with authored works approval procedure. Which in turn triggered 100% signature compliance.

The second challenge that the Naval Medical Center San Diego faces involves management of scarce resources during COVID-19 which is a major challenge. The facility personnel and other relevant executives held a meeting including public health authorities on how to gain consensus on the appropriate way to save many lives with the limited resources available. So the incorporation of continuous procedure enhancement and techniques of communication is vital for successful development (Devereaux et al., 2020). The utilization of regional health-care integrated communication, incident command system and the crisis care committee played a huge role in San Diego in distribution of relevant resources and materials for COVID-19 victims.

The Scope and Magnitude of the NMCSD Challenges

The challenge involves establishment of a county-wide technique for resource allocation and effective communication procedure for the development of crisis care. When this challenge is sorted out, NMCSD will benefit a lot and they would attain enough resources capable to save more lives. The second challenge involves creating awareness to community people of San Diego. The urgency to educate the locals is crucial including hospital systems like NMCSDA concerning the essential steps for systematic process to those not knowledgeable with IOM/NAM including State frameworks. Another essential education should be on the medical staffs working in NMCSD to develop a virtual communication to stay safer from COVID-19 and also encourage patients, the community and the staffs exhibiting similar symptoms to isolate to avert rapid spread of COVID-19. For instance, the hospital systems such as NMCSD can develop Triage Teams and conduct training instruments to the healthcare facilities in San Diego.

The report revealed by WHO in early 2021 displayed that San Diego has a population of 2.4 million approximately. And that even though most public health officials received early management experience with COVID-19 pandemic, the first victim was reported with the virus in March 9th 2020, since then there has been rapid increase in deaths of victims with coronavirus pandemic. Which clearly depict ignorance about the disorder by huge numbers of the community people and Naval Medical Center San Diego included. since there have been different variants of coronavirus, the symptoms also keep changing such as aches and pains, conjunctivitis, sore throat, diarrhea, headaches. Also rash on the skin which are different from the initial signs of the virus such as sneezing and coughing. That is why it is crucial to create awareness about the same to curb the spread of the virus.

How the Challenges have Affected my potential prospective Practicum site

During my observation for both the NMCSD and my parent facility, Moody AFB clinic, I witnessed wide range of the negative impact COVID-19 has had to the people and the military defense at large. It has paralyzed admission and triage process which has forced many patients to go for homecare and utilize mobile healthcare providers who move from one house to another to provide relevant care. The most affected groups are the expecting mothers and according to the hospital records, majority of them no longer attends both prenatal and postnatal care due to the fear of getting infected with the virus.

Besides, lack of ventilators and other useful equipment and resources were lacking which is also the reason, NMCSD has failed to save many lives according to its initial objective. The challenge has influenced negatively the quality of care, hospital operations for the focus has shifted to coronavirus victims and neglected other patients with other ailments. It was also evident that the hospital staffs were not adequate basing on patient to provider ration. Medical professional are less as compared to the huge numbers of patients in need of medical attentions and other related organizational problems. It is a challenge that has paralyzed operations in NMCSD and the affected populations include, children and women including the elderly.

References

Devereaux, A., Yang, H., Seda, G., Sankar, V., Maves, R. C., Karanjia, N., ... & Koenig, K. L. (2020). Optimizing Scarce Resource Allocation During COVID-19: Rapid Creation of a Regional Health-Care Coalition and Triage Teams in San Diego County, California. Disaster medicine and public health preparedness, 1-7.

Valdez, M. M., Liwanag, M., Mount, C., Rodriguez, R., Avalos-Reyes, E., Smith, A., ... & Green, R. (2018). Utilizing Lean Six Sigma Methodology to Improve the Authored Works Command Approval Process at Naval Medical Center San Diego. Military medicine, 183(9-10), e405-e410.

Vicente, D., Maves, R., Elster, E., & Shwayhat DO, MPH, A. (2021). US Navy’s response to a shipboard coronavirus outbreak: considerations for a medical management plan at sea. Military medicine, 186(1-2), 23-26.