PM FPX 4010 Assessment 2 Interview and Interdisciplinary Issue Identification

Student Name

Capella University

PM-FPX4010 Process Groups and Knowledge Areas in Project Management

Prof. Name

Date

Interview Summary

In selecting an interviewee, I aimed to find someone who had been with the organization longer than myself and had experienced departmental changes from various perspectives. I chose to interview my assistant nurse manager, who has been with our organization for five years and has witnessed both positive and negative changes during this period. The hospital where we currently work was acquired by a larger group, leading to numerous changes, many of which are still being implemented. Overall, the new director appears to be supportive of the staff, aiming to empower each individual in their respective roles, whether in environmental services, food service, pharmacy, nurse aids, nurses, management, physicians, phlebotomists, or other personnel. My assistant manager handles charge nurse duties, scheduling, personal time off (PTO), payroll, and PRISM reviews. During the interview, she identified staffing issues on the floor and at the organizational level. We discussed how these problems were being addressed and whether the implemented actions were producing a positive overall outcome.

Issue Identification

A significant issue discussed in the interview was low staffing levels, which strain personnel on the floor and diminish the quality of patient care provided by the team. Although my assistant manager’s role involves overseeing the floor, she often takes on charge nurse duties because the charge nurse is handling patient loads, leaving them overwhelmed and unable to complete other necessary tasks during their shift. Additionally, with a reduced staffing ratio, nurses are assigned higher patient loads, increasing the risk of medical errors. According to Hairr, Salisbury, Johannsson, and Redfern-Vance (2014), “Research on inadequate nurse staffing showed there was a 6% risk of death for patients when a shift with a nursing staff shortage of just 8 hours occurred.”

The issue of nurse-to-patient ratios and understaffing is compounded by the high volume of admissions and discharges, which consumes a significant amount of time and may be rushed if nurses are already overwhelmed. For example, when a nurse has to discharge three patients, complete all the paperwork, and ensure that patients understand their discharge instructions, this limits their ability to care for other patients. Once the patients are discharged, the nurse is responsible for new admissions, which involves reviewing medications, medical history, and other critical information. This revolving door of admissions and discharges, coupled with a high nurse-to-patient ratio, can lead to errors.

Another issue raised was the need for doctors to input their own orders while on the floor, rather than relying on nurses. This becomes especially stressful on days when multiple doctors are rounding on patients, pulling nurses in multiple directions. Collaboration between nurses and doctors is essential to achieving the best outcomes for patient care. As Clausen, Cummins, and Dionne (2017) noted, “Both nurses and physicians are uniquely positioned to co-lead as they represent the largest proportion of healthcare professional staff occupying these leadership positions and are involved in clinical and organizational decision-making.”

Change Theories That Could Lead to an Interdisciplinary Solution

Lewin’s three-step model for change includes unfreezing, changing/moving, and refreezing. “Unfreezing, or creating awareness of a problem, allows for individuals to let go of old ways and undo the current equilibrium. Changing/moving seeks alternatives and demonstrates the benefits of change. Refreezing helps establish the new system and integrate it so that the changes become stabilized” (Wojciechowski, Pearsall, Murphy, & French, 2016). Another approach to implementing change is the Plan-Do-Study-Act (PDSA) method, which allows for testing change on a smaller scale (n.d.).

Leadership Strategies That Could Lead to an Interdisciplinary Solution

As mentioned earlier, the Plan-Do-Study-Act method can be used to initiate change in a smaller environment to determine if it will benefit the organization. One case study explored the use of the PDSA method to implement the role of admission/discharge nurses and examined the economic implications of creating a discharge nurse role on a medical-surgical unit. The problem was identified, a plan was developed and implemented, progress was monitored for three months, and findings were presented to stakeholders (Shimp & Neville, 2017). The PDSA method allows for the study of the effects of the change and its presentation to stakeholders and interdisciplinary personnel.

Collaboration Approaches for Interdisciplinary Teams

When discussing the issues on the unit and ways to implement change, my assistant manager referred to the Team Members As Customers (TMAC) surveys we completed earlier in the year. The primary concern was the need for adequate staffing to ensure patient safety. The only solution to this problem is to hire more nurses and patient care technicians. Another idea suggested by nurses on the unit was the implementation of an admission/discharge nurse to help educate patients and reduce the likelihood of readmissions. Additionally, assigning doctors the responsibility of inputting their own orders could help reduce nurse workload and minimize medication errors.

References

Clausen, C., Cummins, K., & Dionne, K. (2017). Educational interventions to enhance competencies for interprofessional collaboration among nurse and physician managers: An integrative review. Journal of Interprofessional Care, 31(6), 685–695. https://doi.org/10.1080/13561820.2017.1347153

Hairr, D. C., Salisbury, H., Johannsson, M., & Redfern-Vance, N. (2014). Nurse staffing and the relationship to job satisfaction and retention. Nursing Economics, 32(3), 142-7. Retrieved from http://library.capella.edu/login?qurl=https%3A%2F%2Fsearch.proquest.com%2Fdocview%2F1545343826%3Faccountid%3D27965

Institute for Healthcare Improvement. (n.d.). How to improve. Retrieved from http://www.ihi.org/resources/Pages/HowtoImporve?default.aspx

PM FPX 4010 Assessment 2 Interview and Interdisciplinary Issue Identification

Shimp, K., & Neville, B. (2017). Economic implications of creating a discharge nurse role on a medical-surgical nursing unit. Med-Surg Matters, 26(3), 4–6. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=124036016&site=ehost-live&scope=site

Wojciechowski, E., Pearsall, T., Murphy, P., & French, E. (2016). A case review: Integrating Lewin’s theory with Lean’s system approach for change. Online Journal of Issues in Nursing, 21(2), 1. https://doi.org/10.3912/OJIN.Vol21No02Man04