For EXPERT_RESEARCHER ONLY assignment 1-1

Running head: PROFESSIONAL LEADERSHIP 1

Professional Leadership

Proposal for Developing an Interprofessional Team in

Alistair Health Services

Sitara Monnappa

Collaboration, Communication, & Case Analysis for Health Care Master's Learners

Professional Leadership Preparation

January, 2017

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PROFESSIONAL LEADERSHIP 2

Summary

The purpose of this proposal is to help the health care professionals of Alistair Health

Services (AHS)—an organization that provides health care services to thousands of people—

develop an interprofessional team. Such a team will help reduce the number of patient deaths,

which have increased t.ecently due to medical errors, delayed diagnosis or wrongful drug

administration. "Fhis proposal is to improve communication and collaboration in an effort to

better manage patient welfare in AHS through the coordinated efforts of an interprofessional

team.

The increased number of deaths due to medical errors, delayed diagnosis or wrongful

drug administration has placed AHS in a 4ifficu1t situation] The lack of communication among

health care professionals in the organization, along with other factors such as financial

challenges and shortage of physicians, has aggravated the situation. The proposed solution is to

form an interprofessional team that consists of team members from different disciplines in the

organization and select an effective leader to guide the interprofessional team successfully. The

leader of the team will develop a communication plan for doctors, nurses, and other health care

staff to initiate team collaboration. Communication among doctors, nurses, and other health care

personnel will allow the sharing of important information about patients and allow them to

address and resolve problems more efficiently.

The chances of AHS facing such complex issues would be minimized in an alternative

scenario where there are adequate funds to employ more staff, sufficient primary care physicians,

and a cohesive interprofessional team

Comment [Al]: Good identification of the contributing factors

Comment [A2]: A difficult situation meaning....Can you expand on this or define more precisely?

Comment [A3]: Yes, these factors are so important in safe and quality delivery of services.

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PROFESSIONAL LEADERSHIP

I. Introduction

The health care industry is experiencing significant change and as populations grow and

demographics shift, the demand for health services will rise significantly in both the developed

and the developing world. Health care organizations will have to develop more innovative

diagnostic methods and new drug treatments to handle health issues around the world (KPMG

International, 2015). Like other organizations in the healthcare industry, Alistair Health Services

(AHS)--an organization that provides health care services to thousands of people is facing

certain problems, such as an increase in the number of patient deaths due to medical errors,

because of the changing nature of the industry.

II. Problems that have Affected Alistair Health Services

Some of the factors that have contributed to a recent rise in patient deaths because of

medical errors such as delayed diagnosis or wrongful drug administration at AHS are as follows:

a. Lack of communication: Poor communication among health care professionals in

AHS has deterred collaboration and delayed treatment. Doctors, as well as nurses,

often avoid asking questions or avoid seeking the appropriate advice as they are

afraid of being considered medically incompetent. In addition, communication

failures in the organizational hierarchy of AHS have arisen because one group is

afraid of questioning the medical ability or the authority of a group that is higher

up in the hierarchy (Taran, 2011). This has given rise to many information gaps in

patient records and treatment in AHS, which has Contributed to the issue;t

b. Financial challenges: High energy costs and an aging world population are putting

pressure on AHS to satisfy patient needs at minimal costs, without compromising

Comment [A4]: Can you define "medical errors" in this context? Are these medication errors or other issues related to medical care?

Comment [A5]: Good work in describing the problem and the stakeholders involved.

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Comment [A9]: Citing the literature here to support staffing shortages, stress and the effect on patient care

, would add to your point here. Comment [A10]: Good use of the presenting factors to draw some conclusion. The support of the literature here would be useful in making your case for both hand hygiene and staffing levels.

PROFESSIONAL LEADERSHIP 4

the quality of care. The organization cannot afford to hire new staff because of a

shortage of funds. The current staff is overworked and cannot spare much time to

clearly communicate with their peers, leading to medical errors (Sullivan, 2013);

c. Physician shortage: AHS has very few primary care physicians as most medical

students are going into subspecialties instead of primary care. A primary care

physician is often responsible for up to 3,500 patients. The overload of

responsibilities on the physicians leaves them with little time to communicate

important patient-related information to other health care staff on time Barnet et

al., 2014)

III. The Need for Interdisciplinary Collaboration in AHS

These issues emphasize the urgent need for collaboration among health care professionals

from different disciplines in AHS. Interdisciplinary collaboration will allow professionals to

apply their experiences and expertise to alleviate critical health care issues Naylor, 2011).

Communication difficulties have been observed when physicians from different medical

departments of AHS are responsible for treating the same patient. Assigned doctors and nurses

often avoid asking important questions or avoid seeking advice. Miscommunication among

doctors and nurses because of the misinterpretation of symbols in medical records has also been

observed. Patient records about the drugs being administered have been found to be incorrect

probably because of an inability to pay attention as a result of being overworked. nfections have

spread from patient to patient and from patients to doctors because health care personnel are not

maintaining appropriate hand hygiene. All these issues have collectively affected the functioning

of AHS.

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Comment [A6]: So, are these two separate issues, e.g., aging population and increased needs and cost versus staffing to meet these needs?

Comment [A7]: Good support from the literature here. There is a national shortage in this area.

Comment [A8]: Yes.. .a diverse and collaborative team can be creative and innovative in solving and negotiating solutions across disciplines as well as within them.

Comment [A13]: Yes.. .shared decision making with employees who are actually on the front lines is a great strategy for success in this scenario.

Comment [A14]: Good point with support from the literature. What leadership style seems most aligned with these factors and traits?

Comment [A151: Yes..how might this be fostered or encouraged? Can you provide an example?

PROFESSIONAL LEADERSHIP 5

A team consisting of physicians, nurses, pharmacists, patient technicians, and

administrative and support staff would be ideal to effectively meet the objective of quality care

for the patients at AHS. The physicians will diagnose and recommend appropriate treatments for

diseases, while nurses and patient technicians will administer the required medicines and keep

track of patients' recoveries. Physicians and nurses must constantly communicate with the

administrative and support staff so that appointments are not postponed and patients do not have

to face delays in treatment. If all team members coordinate their efforts and communicate

effectively, they can be up-to-date about patients' illnesses and diseases and possibly Prevent

patient deaths.

IV. Proposed Solution

Interprofessional teams require an effective leader that prevents employees from feeling

uncomfortable with change. Leaders must Oevelop emotional and behavioral intelligence.

Emotional intelligence involves being aware of one's own emotions as well as those of others.

Behavioral intelligence involves being able to understand the basis for people's behavior.

Leaders who positively influence their employees' emotions and behaviors tend to bring out the

best in their employees, even in times of change (Delmatoff & Lazarus, 2014). Leaders must also

allow the employees working at the frontline to make decisions and set policie. Autonomy has

been found to lead to more experimentation and innovation, leading to new service delivery

models and more responsibility among health care personne11(Weberg, 2014. Leaders should

encourage backup behavior, which involves team members helping each other when the

workload is unevenly distributed McComb, 2013).1

Leaders should ensure that members of the interprofessional team apply evidence-based

information in practice so that patients are provided high-quality care in a safe and secure

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Comment [All]: Yes.. effective communication and collaboration are essential components here for effective and quality service delivery.

Comment [Al2]: An excellent point

PROFESSIONAL LEADERSHIP 6

environment (Ndoro, 2014). Leaders can arrange seminars and lectures for team members to give Comment [A161: How does this relate to the scholar practitioner model?

them information about the latest evidence-based practices in health care and to develop their

problem-solving abilities. Leaders must establish performance expectations and check whether

or not team members understand these expectations. Leaders must also monitor the internal

environment by collecting feedback from team members periodically (McComb, 2013). A

leader's attitude is found to be reflected in his or her subordinates. If a leader exudes an attitude

of empathy and respect, the subordinates, too, will adopt this attitude and understand each other

better. With shared understanding, teams belonging to different disciplines at AHS can improve

communication and iperform better

To improve communication among the medical staff members of AHS and guide them to

function as a team, leaders at AHS can apply the skills of a scholar-practitioner. Scholar-

practitioners familiarize themselves with the current research about a topic, analyze the available

information, and attempt to find information gaps and solutions to certain problems. Leaders can

identify and review the current status of knowledge about the most effective communication

strategies within interprofessional teams in health care through research analyses and literature

reviews. Then, they can analyze the current knowledge to determine information gaps or needs

for more knowledge about the subject. After obtaining all the available information on the

subject, leaders at AHS can conduct their own research on the lack of communication within the

organization to fill those gaps and create new knowledge to ensure interprofessional teamwork,

leading to better health outcomes. For example, a study was conducted to find the effect of

emotional intelligence on employees in different departments of a health care organization. The

study revealed that certain departments had more change-resisting employees than others

(Delmatoff & Lazarus, 2014). After reading this case study, the leaders at AHS can conduct their

Comment [A171: Well stated.

Comment [A18]: A great opportunity to contribute to the field of practice.

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Comment [A19]: Yes.. .using the best evidence in the field in conjunction with professional knowledge and experience is reflective of the scholar practitioner model.

Comment [A20]: Might include a citation on complexity leadership to support your points here.

Comment IAD.]: . What might this "look like" in practice? Can you provide an example?

PROFESSIONAL LEADERSHIP 7

own studies to understand the specific personality types that resist change so that suitable

measures can be taken to prevent resistance to change. Adopting this evidence-based approach

will help the leaders understand leadership challenges such as communication deficits and lack

of interprofessional collaboration, thereby reducing medical errors that have led to increased

number of patient deaths.

V. A Leader's Approach to Interprofessional Collaboration

The collaboration of teams in AHS will entail many changes for health care professionals

in the organization. An effective leader will be required to guide the teams while these changes

are being implemented.

To be effective, leaders can follow the complexity model of leadership. According to this

model, leaders should manage and navigate teams by interacting with all team members. It is

based on adaptive capacity, understanding the external environment, and connecting with the

internal organizational culture to foster communication and manage change. The effectiveness of

this model in building and maintaining collaborative relationships can be proved by a study that

analyzed certain leadership initiatives based on the model. The leadership styles in six hospitals

were studied to understand the effects of different leadership styles in complex environments,

which were characterized by increasing environmental changes and pressures. Leaders who

respond in ways corresponding to the complexity model were found to enhance organizational

performance (Uhl-Bien, 2012). Leaders can implement this model in practice by making open

discussions about different issues mandatory and by ncouraging feedback. In addition, leaders

could pay attention to the views of the members of each department, communicate with different

departments, and allow shared decision-making to address the needs of the patients and the staff.

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PROFESSIONAL LEADERSHIP 8

This will help leaders improve networking, facilitate distributed decision-making, and help the

organization adapt to the pressures of change effectively (Weberg, 2012).

VI. A Plan for Effective Communication in an Interprofessional Team

Some of the strategies that the management of AHS can use to ensure collaboration and

build respect and trust among all the team members of the interprofessional team are listed

below.

a. The management of AHS should arrange regular medical team meetings

consisting of doctors, nurses, and other staff members to encourage problem-

solving, collaboration, record-keeping, and decision-making in the organization.

These team meetings can also address the cultural differences among team

members and make them more sensitive toward each other. This will also help

health care personnel communicate clearly with a culturally diverse set of

patients;

b. The management should make appropriate, complete, and up-to-date information

about patient records available to the team lincluding real-time data entry display

that captures information) to draw the team's attention to every patient's status,

decisions about care plans, and tasks assigned. This can reduce the number of

patient deaths (Kane, 2011);

c. The management should create a list of commonly used symbols for all health

care personnel to follow to avoid confusion. Miscommunication through

misinterpretation of medical symbols can be avoided by standardizing these

Comment [A22]: Good work here in addressing this style of leadership. How might leaders be equipped to address this type of work in practice? Training, leadership development, mentoring?

Comment [A23]: How might this be accomplished? Examples?

Comment [A24]: Assume this is the "treatment team" per HIPAA, etc.

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PROFESSIONAL LEADERSHIP 9

symbols, thus reducing the chances of wrong treatment and the number of patient

deaths [(Kane, 2011); L

d. The management of AHS can ensure a common understanding of organizational

challenges by collecting well-organized inventories of work-related problems

from all team members to implement effective processes and solutions

l(Nystrom, Terris, Sparring, Tolf, & Brown, 2012).

e. A simulation center can be set up where team members can practice responding

together to emergency situations, such as cardiac arrests at the emergency

department. Health care professionals can learn from any mistake they make

during training without finger pointing and without harming a patient. This will

nurture respect and trust for each other's roles and responsibilities l(Wood, 2012); I

f. The AHS management should keep track of hospital funds while preparing to lead

an interprofessional team so as to avoid bankruptcy. Care should be taken while

purchasing new equipment and resources to train the staff. The management

should appoint a financial adviser to avoid debt. The AHS management should

provide monetary concessions for low income patients as long as it does not affect

the economic health of the organization;

g. Organizational policies may have to be modified to suit the dynamic environment

of the hospital. The AHS management should interact with the organization's

ethics committee regularly to ensure that no policy violates any of the ethical

principles, such as the principle of beneficence and the principle of

nonmaleficence, which safeguard patients' well-being; lan

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Comment [A25]: Yes, does training need to occur for health care personnel related to medical records, terminology, etc.?

Comment [A26]: Good, giving a voice to team member and empowering them to address these issues is a great asset.

Comment [A27]: An excellent suggestion.

Comment [A28]: Good, how does fiscal responsibility align with ethical practice?

Comment [A29]: Good, these are critical points here related to ethical practice and leadership.

Comment [A30]: Good, employing a diverse team may lead to creative and innovative strategies in this area. Providing positive feedback is a great way to empower and encourage staff.

Comment [A31]: Good, evaluation is a critical component of this process.. .a circular event where evaluation leads to new strategies and implementation.

PROFESSIONAL LEADERSHIP 10

h. In team meetings, feedback can be given to team members through reports and

PowerPoint presentations. This feedback should highlight improvements in the

quality of care and the areas for improvement. Overtly critical feedback may

demotivate team members and hamper the success of the team Kane, 2011).

By following these strategies, the interprofessional team can reduce the number of

medical errors at AHS. However, the progress of the team will have to be monitored to ensure

that the confidence of the stakeholders toward the organization is intact

VII. Strategies to Report Team Progress to the Stakeholders of AHS

The stakeholders of AHS will need to be aware of the progress of the interprofessional

team and the functioning of AHS as an organization. Implementing the following strategies will

help keep the stakeholders of AHS informed about the progress of the interprofessional team:

a. Periodic progress reports should be provided to the stakeholders, executives, and

administrative leaders of AHS. These reports will discuss matters such as

accomplishments, encountered problems and their resolutions, and financial

performances. It will allow the stakeholders to evaluate the progress made against

their expectations. Progress reports will help stakeholders understand project

goals and team progress, and attract the funding required for future investments in

AHS. Ensuring positive experiences for patients can help the organization build

effective long-term relationships with the patients based on ;trust (Linton, 2016)

b. Problems can be communicated to the stakeholders according to the t.trgency of

actionlrequired through the RAG Status Report. In such reports, problems are

Comment 1A32]: Good, who will present these reports?

Comment [A33]: An excellent way to prioritize.

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PROFESSIONAL LEADERSHIP 11

coded as the colors of a traffic light red for immediate action required, amber

for requirement of notification, and green for no action required (Martens, 2014);

c. The improvement in the quality of health care can be assessed through peer

reviews. This will allow the interprofessional team to benchmark itself against

'similar teams. The results of the assessment will be shared as reports, with ratings

given for the performance of each team member on different criteria such as

communication and cooperation. The team can convene every three months to

evaluate the results of the assessment and reprioritize the goals of the team

(National Cancer Action Team, 2010).

d. As the different stakeholders—health care staff, patients, employers, and

investors—have different perceptions of quality improvement, progress reports

may not convey team progress clearly to all of them. Health care staff tends to

view quality in a technical sense—precision of diagnosis, choice of therapy, and

the health outcome that follows treatment. Patients measure quality in terms of

compassion, skill, and clarity of communication. Employers consider the quality

of health care good if their costs are minimal and their employees can return to

work as quickly as possible. Investors measure the quality of a project or program

in terms of cost effectiveness (Duke University School of Medicine, 2016).

Because progress reports may not consider the perspectives of all the stakeholders

of AHS (McDonald & Hammer, n.d.), details of these reports may have to be

modified to appeal to all the stakeholders. The AHS leaders can use the feedback

of different stakeholders to make decisions that will improve i)atient outcomes.1

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Comment [A34]: Great idea.

Comment [A351: Good points.. Is it possible to educate regarding the value of different perspectives and the opportunities this brings to the group and organization?

PROFESSIONAL LEADERSHIP 12

e. Feedback about the functioning of the interprofessional team from the

stakeholders will help the team members understand the progress of the team and

work on the areas that require improvement. Positive feedback will imply that the

quality of care has improved and means that communication among the health

care staff of AHS l-ias improved.

Conclusion

The ultimate goal of AHS is to ensure patient safety. Considering that most of the patient

deaths in the past have been due to a lack of communication among health care providers from

different disciplines, the best way to prevent such incidents in the future would be to encourage

effective communication and to improve collaboration among doctors, nurses, and other health

care staff working in AHS. This will ensure that the medical errors in the organization reduce

and the health outcomes of i)atients improve

Comment [A36]: A very well developed section for this component.

Comment (A37]: A fine proposal to address this issue with a interprofessional team.

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PROFESSIONAL LEADERSHIP 13

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PROFESSIONAL LEADERSHIP 14

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PROFESSIONAL LEADERSHIP 15

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