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Section #2

To be completed by Learner

2.1 Project

Write approximately one paragraph that describes the action research project and the basis for it being addressed.

The action research project seeks to explore pertinent leadership effectiveness issue created by the healthcare reform process in healthcare institutions across the United States. The reform process has created a dynamic environment that is in constant flux. Essentially, healthcare reform institutionalization has proven to be very beneficial when it comes to reducing the rising cost of healthcare. Additionally, it helps ensure that effective delivery of primary care is achieved so as to diminish the prevalence of chronic illnesses such as diabetes and cardiac-related health problems. The shift towards preventive care for the reduction of chronic illnesses requires more engagement between the patients and the doctors and closer follow-ups of patient outcomes. This requires effective leadership when it comes to the creation a workforce that is responsive to long-term patient needs. This means the healthcare professionals such as the physicians and nurses need effective leadership in hospital management so as to ensure they are motivated and engaged in the change process through teamwork and partnerships within hierarchical structures. Nonetheless, the purpose of this action research is assess Micheal E. DeBakey VA Medical Center of Houston’s leadership so as to provide a leadership model that includes the most appropriate leadership qualities that can be adopted by the organization to create a dynamic healthcare environment. Essentially, the action research project will involve a qualitative analysis of case studies related to leadership mechanisms within the institution and how they influence employee and patient outcomes. Based on the findings of the studies conducted, the possibility of using the proposed leadership model to improve outcomes will also be gauged. Comment by Nita Stika: What example would you use to demonstrate how this is true? Comment by Nita Stika: Management, observation or as Dr. Z suggests. Comment by Nita Stika: To assess Comment by Nita Stika: Current administrative structure so as to construct a leadership model that includes the most compatible qualities to be adopted? Comment by Nita Stika: Again, a forgone conclusion, could.

Reference

Thompson, J.M. (2007). Health Services Administration. Sudbury, MA: Jones and Bartlett.

Dageling, P. and Carr, A. (2004). Leadership for the systemization of health care: the unaddressed issue in health care reform. Journal of Health Organization and Management, 18(6), 399 – 414.

2.2 Contribution to Society

Using citations, answer the following questions in order:

1. How does your project improve a current practice?

2void . If your action research project is successful, how could your project impact your field of interest?

3. What are the practical implications of your project? For example, what will be the impact of this project on your sample, your site location, or your workplace?

1. If the action research project is successful, it could provide an excellent framework for the leadership of Michael E. DeBakey VA Medical Center and other healthcare organizations to enhance the delivery high quality care outcomes to patients and favorable working environment for employees.

2. Successful completion of the research will contribute a lot to the identification and determination of the best solutions to some healthcare malpractices. These malpractices include corrupt insurance claims and misdiagnosis, which could lead to increased effectiveness of service delivery to patients when addressed effectively. Comment by Nita Stika: should

3. The research will provide an action plan for the organization to develop actionable strategies that can be employed to enhance employ recruitment and development. This way, Michael E. DeBakey VA Medical Center will be able to recruit physicians who practice the tenets of affordable, high quality care, particularly in line the Affordable Care Act. Comment by Nita Stika: intends to strives to, watch absolutes or avoid drawning conclusion before you have the data or information to do so.

Reference

Dageling, P. and Carr, A. (2004). Leadership for the systemization of health care: the unaddressed issue in health care reform. Journal of Health Organization and Management, 18(6), 399 – 414.

2.3 Need and Evidence to Make Change

Provide current information on your needs assessment or analysis for change. Include the cost-benefit analysis if indicated by design.

The American Hospital Association (2013) highlights the need for change in human resource planning through workforce planning. This is the process of estimating current and future workforce needs and developing a workforce plan to reduce the gap between the current and future needs. Workforce planning is necessary because the healthcare system is increasingly dynamic and subject to change. Institutions need to ensure there are adaptive systems for the change process. The cost would be increase the need for workforce deployment and engagement to deal with the change process, which can be accomplished through effective communication and training. The benefit is the improved adaptation to the dynamic healthcare system and speedy implementation of healthcare reforms that facilitate the delivery of quality of care to patients.

Reference

American Hospital Association. (2013). Developing an Effective Health Care Workforce Planning Model. Retrieved July 16, 2015, from

http://www.aha.org/content/13/13wpmwhitepaperfinal.pdf

2.4 Theoretical Foundation

Describe the theory or theories that serve as the backbone of your project. Provide references for each theory.

Shared leadership is the theoretical approach adopted for improving leadership effectiveness in the healthcare system. This model of leadership includes a systems thinking of the organization as an organism that is influenced by internal and external factors (Thompson, 2007; Luckett & Grossenbacher, 2003) that charts its course towards patient and employee outcomes such as improved employee and patient satisfaction, as well as high quality care based on reduced number of readmissions. Other important aspects of the proposed leadership model that makes it relevant to the dynamic healthcare environment include transformational leadership (Atkinson, 2011), improvement of human resource management (Robbins & Davidhizar, 2007), and the creation of teamwork in horizontal hierarchies in organizational subcultures (Wood, 2005).

References

Atkinson, S. (2011). Are you a transformational leader? Nursing Management, (September, 2011).DOI:10.1097/01.NUMA.0000403279.

04379.6a

Luckett, S. & Grossenbacher, K. (2003). A critical systems intervention to improve the Implementation of a District Health System in Kwa Zulu-Natal. Systems Research and Behavioral Science 20,147–162.

Wood, M. S. (2005). Determinants of shared leadership in management teams. International Journal of Leadership Studies, 1(1), 64-85.

2.5 Researcher Positionality:

· Insider

· Insider w/collaboration

· Reciprocal collaboration

· Outsider, collaboration w/ insiders

Define your role, position, and how positionality will impact your research study.

The researcher position is more like a combination of both outsider and insider collaboration to improve the knowledge base as well as widen the scope of the action. In order, to accomplish this goal, the researcher will collaborate with the human resource, physicians, and the staff at Michael E. DeBakey VA Medical Center. This position will allow for objectivity since the researcher will not have any conflict of interest between the research needs and the organizational influence. Collaboration with insiders intends to enhance the acquisition of crucial information, including the formal and informal organizational mechanisms that can help in obtaining a clear picture of the leadership structures and practices in the organization. Comment by Nita Stika: Intends to Comment by Nita Stika: Should, be careful of drawing conclusions for all interested parties before the research has been done.

2.6 Research Questions and Project Goals/Objectives

List the research questions or project goals. These should align with the need for organizational structure or activities/ outcomes of the project.

Research questions:

· How can the outcomes as a result of the changes in the health care environment be sustainable? Comment by Nita Stika: Grammar could the outcome from the resulting changes….

· How conducive is the hierarchical leadership model at the hospital with regards to the best practices in human resource and patient care? Comment by Nita Stika: How conducive is the hospital’s hierarchical leadership model with regard to….watch grammar and word alignment.

· How do business considerations take precedence over the quality of care for patients?

This is the other committee member and the mentor comments

Section #2

To be completed by Learner

2.1 Project

Write approximately one paragraph that describes the action research project and the basis for it being addressed.

The action research project seeks to explore pertinent leadership effectiveness issues created by the healthcare reform process in healthcare institutions across the United States. The reform process has created a dynamic environment that is in constant flux. Essentially, healthcare reform institutionalization has proven to be very beneficial when it comes to reducing the rising cost of healthcare. Additionally, it helps ensure that effective delivery of primary care is achieved so as to diminish the prevalence of chronic illnesses such as diabetes and cardiac-related health problems. The shift towards preventive care for the reduction of chronic illnesses requires more engagement between the patients and the doctors and closer follow-ups of patient outcomes. This requires effective leadership when it comes to the creating a workforce that is responsive to long-term patient needs. This means healthcare professionals, such as physicians and nurses, need effective leadership in hospital management so as to ensure they are motivated and engaged in the change process through teamwork and partnerships within hierarchical structures. The purpose of this action research is to assess Micheal E. DeBakey VA Medical Center of Houston’s leadership so as to provide a leadership model that includes the most appropriate leadership qualities that can be adopted by the organization to create a dynamic healthcare environment. This action research project will involve a qualitative analysis of case studies related to leadership mechanisms within the institution and how they influence employee and patient outcomes. Based on the findings of the studies conducted, the possibility of using the proposed leadership model to improve outcomes will also be gauged. Comment by Heather: You might want to give an example of some concrete issues (example, accountability, medical documentation, malpractice, etc) Comment by Heather: I get the point of this sentence, but it reads a little confusing. Comment by Heather: Change to either monitoring or surveillance. Follow-up is to informal. Comment by Heather: This point is much better received now!! Comment by Heather: How will you be providing this leadership model? Will you be creating a new model through your action research? Is there a model that already exist that you will be incorporating through your study? Comment by Zerwekh, Tyler: This sounds like you have a proposed model already in mind?

Reference

Thompson, J.M. (2007). Health Services Administration. Sudbury, MA: Jones and Bartlett.

Dageling, P. and Carr, A. (2004). Leadership for the systemization of health care: the unaddressed issue in health care reform. Journal of Health Organization and Management, 18(6), 399 – 414.

2.2 Contribution to Society

Using citations, answer the following questions in order:

1. How does your project improve a current practice?

2void . If your action research project is successful, how could your project impact your field of interest?

3. What are the practical implications of your project? For example, what will be the impact of this project on your sample, your site location, or your workplace?

Leadership is a dominant issue in healthcare reform, not only in the United States but also in other countries where health reforms are being implemented. Dageling and Carr (2004) conducted a study on the improvement in performance in reform implementation in Australia and England, and their findings revealed the absence of appropriate leadership models that include subcultures within the leadership framework contribute to a disconnect between expectations and outcomes. Through an in-depth investigation of case studies on healthcare reform in various settings, the researcher will suggest appropriate leadership models that fail to take into account the importance of social constructs that end up producing less than optimal results. For similar reasons, the action research process hopes to change the hierarchical model of leadership in implementation in most healthcare institutions through the shared leadership model that takes into account horizontal social dynamics in leadership effectiveness. This is similar to Dageling and Carr’s (2004) suggestion that leadership should pass authority to the subcultures that exist within an organization’s management hierarchy. Comment by Heather: As I read this section, I cannot help but to think that you are already making an assumption that the VA Medical Center you will be using as your site is already in need of improvement and lacks in leadership for employee and patient outcomes. You cannot make this assumption. Your study may find that the current leadership model leads to satisfactory patient outcomes. Be careful of how you state things as to avoid creating inferences not based on your research findings. Comment by Zerwekh, Tyler: Completely agree with Heather; it’s a leading statement

4. If the action research project is successful, it could provide an excellent framework for the leadership of Michael E. DeBakey VA Medical Center and other healthcare organizations to enhance the delivery high quality care outcomes to patients and favorable working environment for employees.

5. Successful completion of the research will contribute a lot to the identification and determination of the best solutions to some healthcare malpractices. These malpractices include corrupt insurance claims and misdiagnosis, which could lead to increased effectiveness of service delivery to patients when addressed effectively.

6. The research will provide an action plan for the organization to develop actionable strategies that can be employed to enhance employ recruitment and development. This way, Michael E. DeBakey VA Medical Center will be able to recruit physicians who practice the tenets of affordable, high quality care, particularly in line the Affordable Care Act. Comment by Zerwekh, Tyler: Same as the previous page; statement is leading. Consider revising….possibly using wording like….: “….if the data supports the hypothesis, then necessary strategies could be implemented by the organization to……”

Reference

Dageling, P. and Carr, A. (2004). Leadership for the systemization of health care: the unaddressed issue in health care reform. Journal of Health Organization and Management, 18(6), 399 – 414.

2.3 Need and Evidence to Make Change

Provide current information on your needs assessment or analysis for change. Include the cost-benefit analysis if indicated by design.

Reference

American Hospital Association. (2013). Developing an Effective Health Care Workforce Planning Model. Retrieved July 16, 2015, from

http://www.aha.org/content/13/13wpmwhitepaperfinal.pdf

2.4 Theoretical Foundation

Describe the theory or theories that serve as the backbone of your project. Provide references for each theory.

Shared leadership is the theoretical approach adopted for improving leadership effectiveness in the healthcare system. This model of leadership includes a systems thinking approach of the organization as an organism that is influenced by internal and external factors (Thompson, 2007; Luckett & Grossenbacher, 2003) that charts its course towards patient and employee outcomes such as improved employee and patient satisfaction, as well as high quality care based on reduced number of readmissions. Other important aspects of the proposed leadership model that makes it relevant to the dynamic healthcare environment include transformational leadership (Atkinson, 2011), improvement of human resource management (Robbins & Davidhizar, 2007), and the creation of teamwork in horizontal hierarchies in organizational subcultures (Wood, 2005).

References

Atkinson, S. (2011). Are you a transformational leader? Nursing Management, (September, 2011).DOI:10.1097/01.NUMA.0000403279.

04379.6a

Wood, M. S. (2005). Determinants of shared leadership in management teams. International Journal of Leadership Studies, 1(1), 64-85.

2.5 Researcher Positionality:

· Insider

· Insider w/collaboration

· Reciprocal collaboration

· Outsider, collaboration w/ insiders

Define your role, position, and how positionality will impact your research study.

The researcher position is more like a combination of both outsider and insider collaboration to improve the knowledge base as well as widen the scope of the action. In order to accomplish this goal the researcher will collaborate with the human resources department, physicians, and the staff at Michael E. DeBakey VA Medical Center. This position will allow for objectivity since the researcher will not have any conflict of interest between the research needs and the organizational influence. Collaboration with insiders will allow for the acquisition of crucial information, including the formal and informal organizational mechanisms that can help in obtaining a clear picture of the leadership structures and practices in the organization. Comment by Heather: But does collaboration make you an insider? Do you work for the VA? Comment by Zerwekh, Tyler: Agreed with Heather….if you are employed by them there could be a conflict of interest at THAT SITE (you work at). You may want to consider analyzing another VA hospital or other hospital in the TMC.

2.6 Research Questions and Project Goals/Objectives

List the research questions or project goals. These should align with the need for organizational structure or activities/ outcomes of the project.

Research questions:

· How can the outcomes as a result of the changes in the health care environment be sustainable? Comment by Zerwekh, Tyler: This is a very broad research question. Are you looking at the physical environment? Social environment? Financial environment? I think if you make this question a little more specific it would help better frame your intended data collection.

· How conducive is the hierarchical leadership model at the hospital with regards to the best practices in human resource and patient care? Comment by Heather: I think you could separate this into two individual research questions. 1) How conducive is the hierarchical leadership model used in the hospital with regards to best practices in HR? 2) How does the hierarchical leadership model impact physicians’ delivery of patient care?

· How do employees rate their level of satisfaction at the selected organization? (This will be measured based on the responses obtained from an interview with the members of staff at Michael E. DeBakey VA Medical Center). Comment by Heather: Again, how does this impact patient care? Need to be able to make an association between employee satisfaction and clinical outcomes for patients.

· How do business considerations take precedence over the quality of care for patients?