Week 6 -Class

Instructions: Reply to the threads of at least 2 classmates.

Each reply must be at least 450 words.

Each reply must also include a biblical integration and at least 2 peer-reviewed source citations in current APA format in addition to the text.

Trend 1

The Surgical Care Improvement Project (SCIP) is a national program aimed at reducing the incidence of surgical site infections (SSIs). It includes elements such as ensuring a patient is provided instructions and supplies for completing an anti-microbial bath prior to surgery, insuring that prophylactic antibiotics are administered within a certain time frame and that an indwelling catheters are removed within 24 hours (McCarron, 2014). The adoption of a project of this magnitude by countless hospitals across the nation requires a certain level of education and training to be provided to all those roles that are involved in the surgical work flow, from pre-surgical work-up all the way through discharge from the inpatient unit. One of the most significant and broad reaching strategies that I recall from my hospital days was the implementation of a surgical work flow chart that was added to the chart of all patients who presented for surgery. This check-list was added to each of the pre-surgical work-up packets and followed the patient from work-up then to pre-op, OR, recovery room, and finally to the post-surgical unit. It served as constant reminder to follow each of the newly implemented protocols that were adopted as part of the SCIP initiative.

We learn in our text this week that training and development objectives must address four different elements that are all dependent on one another: relevance, resonance, efficiency, and immediate usefulness (Pynes & Lombardi, 2011). As the administrator in charge of ensuring that training was delivered to each of the individuals involved in any and all portions of the surgical work-flow, I believe I would need to employ several different strategies for ensuring the training is completed. When designing and implementing training and education, one of the most important aspects of developing that training is understanding your learners. Some individuals are visual learners, some tactile, some auditory, and others still any combination of the three. I think an effective training program encompasses all of these styles and ensures that the information being presented is done so to the learning preference of the majority of the intended learners (Rowe, de Savigny, Lanata, & Victora, 2005).

That being said, there are several different approaches that could be taken to ensure delivery of the training materials. There are computer-based learning modules that could be made available. These could be broken out into sub-sections so that each role only needs to complete a module that gives a high-level overview of the needed changes and areas of focus, in addition to role specific training that is applicable for their portion of the work-flow. This would enable each role for whom training is required the opportunity to access the training information at their convenience without having to conform to a scheduled list of classes. Additionally, in-services could be provided by the charge nurse staff for each of the respective areas. This would give individuals time and a forum where they can ask questions and seek clarification on any elements that aren't readily understood. Further, many hospitals offer an annual skills-lab for many of the roles. Training on the importance of SSI reductions and the implementation of the check-list/work-flow chart. A surgical patient could be set-up to represent different stages of the surgical process and each role could identify the missing or incorrect elements respective to each of their areas. This would allow for engaging staff in a non-traditional way that may help them to retain the information better.

We read in Proverbs 1:5, "Let the wise hear and increase in learning, and the one who understands obtain guidance." It is imperative that as health care workers, we continue to strive for increasing our knowledge. Staying abreast of new skills, techniques, treatments, and therapy options ensures that we keep our patients safe, free from harm and continually provide the highest quality of care to those in our charge.

Trend 2

    I always wish I had read your post before I do mine, however, I was originally taught not to do that as it contributes to groupthink in opposition to independent originality. I agree with the four elements, usefulness, efficiency, resonance, and relevance cited for training and development as a basis for an ongoing process. I am very much a process person of which shows in most of my posts and is apparent in my overall efficiency management ideology however, in this post I may be out of the box in my thinking.  It may be my 20 years of experience in Public Administration and working for governmental agencies that I look at the overall process to problem resolution and not the ‘specific problem.’ Governmental agencies are always underfunded, as are rural hospitals and publicly funded hospitals, therefore, developing a problem non-specific methodology process that can be tweaked for use in all situations becomes a time and money saving technique for a program manager (Pynes & Lombardi, 2011). In the reference by McCarron, the use of these four elements is apparent. For the first, the immediate usefulness of the patient specifics including diabetes, nicotine use, obesity or malnutrition or the use of immunosuppressive medications. Now, this process change comes in for of the preoperative notification literature for the suspension of certain medications, critical monitoring of glucose levels before, during, and after surgery for patient care handouts. Then the inclusion of proper pre-surgical prep to include removal of site hair, sterilization of local surgical areas in the best practices for the surgical protocols for efficiency. When it’s relevant using “prophylactic antibiotic” (Preventing SSIs) as part of the surgical protocols and best practices. After all these steps are taken a best practices ‘process’ by which required procedures for SSIs prevention are instituted (McCarron, 2014).

            While the Rowe et al., the study is beyond the 10 years time line (2005), it offers credible support of the idea that resources contribute to an ongoing improvement of processes in the healthcare industry.  When resources lack, then the updating of processes fails. This means it is important to maintain workable ongoing continual quality improvements thereby updating process as part of the effort to keep knowledge current and distributed among the operational staff. Guidelines are costly to maintain, distribute, and update, however, they are the critical part of the ongoing process for quality improvement processes. Policymakers should cooperate with managers to implement strategies for ongoing leadership process within the organizational structure, regardless of the size of the organization if risk management is to prevail and quality services are to be maintained (Rowe, de Savigny, Lanata & Victora, 2005).

        “The mission of the public health system is to improve and protect community health” (Shi, 2017). This mission may differ from private healthcare organizations however, the AMA ensures regulations for standardized processes and procedures for the medical professionals under its regulatory sphere. Therefore there is always a minimum standard for professionals. Although Americans’ generally expect exceptional care, other countries are not so spoiled and are very happy to have access to minimal healthcare services. When judging service qualities, there is some area for subjective judgments, however, when dealing with surgical errors, then the standard of objective judgments must guide our ways. Surgical processes are standardized by the AMA guidelines and so should the judgment of errors.  Any processes that can ensure the reduction of risks of which is vital to the customer-patient relationship and should be updated, regardless of the costs of implementation (Shi, 2017).

            One of the scriptures that I rely on when resources are bleak is, “But my God shall supply all your need according to his riches in glory by Christ Jesus” (Philippians 4:19, KJV). I love the first word in that scripture, but.  It means despite all that went before it, all that means it cannot be done, then God steps in to supply the need. He is faithful to perform it.