Introduction
The nursing practice and profession are experiencing significant changes due to the ever-increasing burden of diseases, the aging population, the adoption of digital care programs, and multiculturalism. It is vital to adopt work on continuous improvement through problem resolution and quality assurance (Larivee, 2019). Evidence-based research is often used as the basis for initiating a positive change. The health and health services department of the United States has the Agency for Healthcare Research and Quality (AHRQ) branch whose goal is to ensure the delivery of safer, equitable, and affordable care (Larivee, 2019). Despite being one of the leading nursing homes in the United States, the Genesis Health Care Corporation can benefit from a performance improvement.
Brief Overview and Licensure of Genesis Corporation
Genesis Healthcare is a federally qualified center that operates non-profit facilities in Pee Dee county and South Carolina. The organization offers a wide range of healthcare services for people of all ages. It is community-based and provides treatment to different insurance options, including Medicaid and Medicare (“Find out,” 2022). The nurse is an integral part of the workforce and usually operates in shifts. The mission of the company is to offer a healthcare system that is compassionate, trustworthy, innovative and upholds excellence (Accreditation, 2022). In 2022, Fortune Magazine recognized Genesis as one of the top 100 hospitals. In addition, it has a four-star rating which only 29% of hospitals in the United States manage to achieve (Accreditation, 2022). The hospital has won several awards through its commitment to operating a high-level health care center.
The hospital is fully licensed to provide clinical operations for people throughout the country. The Accreditation Commission accredits Genesis for Health Care (ACHC) which is recognized by the state and federal government as well as insurance companies (Accreditation, 2022). Furthermore, the hospital is licensed by the Centers for Medicare & Medicaid Services (CMS). The other certifications include: the American Board for Certification (ABC) of Orthotics and Prosthetics, Commission on Cancer (COC) license, and the American College of Radiology (ACR). Thus, it legally and ethically operates all the departments and provides all the healthcare services.
Purpose
Nursing care involves handing over clear and straightforward clinical information regarding a patient from an outgoing to incoming nurse to enhance the continuum of care. Particularly, when nurses are changing shifts they must provide they need to effectively communicate critical information about the treatment plan and the conditions of a patient (Allah, 2022). The practice involves the transfer of information, data, authority, and the primary duty from one or more nurses to the oncoming personnel. Thus, the sender and the receiver transfer their care roles within a complex organizational structure and culture.
Noteworthy, any mistake or miscommunication during the handoffs, handovers, signoffs, and shift change directly affects a patient’s health and safety. According to Hada & Coyer (2021), handover interventions are associated with improved patient outcomes, especially regarding falls, medication administration, and pressure injuries. Some researchers recommend adoption of bedside handover practice whereby the incoming and the outgoing nurses exchange the patient data in the presence of the patient (Forde, Coffey, & Hegarty, 2020). The practice is effective and increases the relationship between the patient and their healthcare provider. However, there are several challenges and issues that nurses experience during the handover. The purpose of the Genesis improvement plan is to enhance health-related communication about each patient during changes in shift.
Responsibilities and Functions
For any improvement plan to succeed, the concerned team must be given responsibilities and functions. The nurses play an important role in quality improvement but have to liaise with other healthcare professionals, administrators, and other accreditation personnel. Moreover, even the patient and their family and friends play a vital role in healthcare improvement. The improvement plan must have a nurse executive whose function includes setting up the structure and resources necessary for the improvement plan (Larivee, 2019). The nurse manager oversees other staff related to the improvement plan while motivating them to embrace the change. The other relevant personnel is the quality assurance coordinators, whose primary role is the execution of quality improvement through collecting data that accredits the organization as meeting the requirements set by regulatory and insurance agencies.
The administrators are responsible for working with the nurses to ensure that there are specific policies on shifts. For instance, Genesis can adapt the bedside handover practice and implement the rules for nurses to follow. In addition, the administrators should ensure that the nurses showing the strongest commitment to the improvement plan are rewarded. The licensing authorities are responsible for assessing the quality standards after the improvement and accrediting, certifying, or awarding the performance. If there is a compromising on the quality of life and safety of the patient, they can revoke the licence to encourage high standards. Patients and the non-professional caregivers have a responsibility to ensure that they ask questions and ensure that they follow the treatment regimen.
Goals and Objectives Based on the Healthcare Environment Goals
Genesis Health Care corporation’s overall mission is to provide timely, compassionate, affordable, and high-quality preventive and primary medical care. The healthcare environment of the corporation is diverse as it serves people from different communities. Therefore, the objective is to ensure that all nurses are competent in providing multicultural care to all patients regardless of their ethnic backgrounds. The other objective is to ensure that there are conditions necessary for the handover practice. The nurses will have to coordinate to ensure that each patient receives individualized care.
Moreover, Genesis healthcare is a large organization that serves patients with multiple conditions. One patient can get admission to oncology department and then later transfer to the general ward. During the transition, miscommunication is likely to occur and affect patients’ progress. The goal of the project is to ensure that as patients transit from one department to another. The objective is to ensure that the administration sets up a teamwork structure to follow when moving patients from one area to the other. The other objective is to involve the relatives and friends of the patient during transfers to help achieve better continuity of care.
Goals and Objectives: Overview
- To establish a team of nurses with a unified vision and agenda for efficient bedside handover practice.
- To provide an internal memo to all nurses and other medical staff stating the interest of change of practice in handover practices by the end of three months.
- To train the staff on the requirements of the change of practice within two weeks after the release of the memo and brainstorming to enable the nurses to embrace the practice.
- To set up a policy that obliges all the nurses to adhere to the requirements of the bedside handover at all times once the program is officially launched.
- The other goal is to ensure that there are designated people and resources set aside for the ultimate success of the project.
- To create a budget and set aside the estimated finances for running the program before its total embrace.
- To choose the nurse leader whose role will be ensuring that the complaints and suggestions of the nurses about the project are taken seriously, adjustments made to have a smooth change.
- To establish the healthcare measure of success and select a person responsible for regular assessment and evaluation of practice to determine if there is progress.
- To promote evidence-based practice by using the findings to make further improvements during the shifts (Hada, Jones, Jack & Coyer, 2021).
- To be a leading healthcare organization with the least probability of errors resulting from a communication breakdown during handover.
Mission
The mission of the project is to improve the quality of care of the patients by enhancing coordination and cooperation between the nurses when changing the shift. The project will ensure that medical errors in drug administration, such as overdose, are reduced. Moreover, the patient is directly involved in the staff shifts, or if they are unable due to their medical conditions, their relative can be present during the transition time. The process will offer them an opportunity to ask a question and develop trust with the people that the
Authority
Various people have different authorities in ensuring that the project driven change is seamless. The administrators have the authority to accept the project and work with others in ensuring that the project succeeds. The nurse leader has the authority to monitor the progress of the change and working with the team of nurses to discuss any challenges and make revisions. The licensing bodies are mandated to do assessments to ensure that the project is within the nursing practice. For instance, the Health Information and Quality Authority (HIQA) has the capacity to check the practice and determine its consistency with the legal requirements before approval (Forde, Coffey & Hegarty, 2020). All accreditation organizations have the authority to assess whether the practice is legal, ethical, and beneficial before giving a certification. Moreover, the patients and their relatives have an authority over their data and can choose to decline treatment procedures and seek a second opinion.
Scope
The project is limited to the Genesis Healthcare corporation only and will not extend to other affiliate organizations, even if there is a possibility that they benefit. Moreover, the focus of the shift is on the medical nurses and not other unprofessional caregivers or the doctors. The planning and implementation stage requires the input from other professionals. However, the success or failure of the project depends on the commitment of nurses in the projects. Noteworthy, there are several processes and activity in the healthcare organization that requires improvement the limit of the project is the nurses at Genesis corporation. In addition, the change is only based on the handover practice during shifts. If there are other needs for performance improvement, it will be done as a separate project. In addition, the project is limited by the budgetary allocations for training and finances to invest in other necessary resources.
Review Process
Review of a project on an ongoing basis is vital in ensuring that the goals and objectives of the project plan are achieved. The review process should be done on a consistent and regular manner. In addition, it is vital to ensure that the correct tools are used in the reviewing process. If possible, the measurements can be done using instruments that are reliable and valid. They should be purchased from the legal owners and not pirated. Alternatively, when using existent data, it is vital to ensure that they are useful in measuring the desired areas.
For the current project, the review will be done using the changes in data by evaluating the pre-intervention and post-intervention. For instance, the data on medication errors for inpatients before and after three months of implementing the bedside handover practice will be assessed using statistical and mathematical analysis. The findings on the differences in the percentages, mean, and medium can help in judging whether the intervention has a positive improvement. In addition, the review can take the form of semi-structured interviews where the patients, their relatives, and the nurses explain their experiences. The responses can be used to enhance the adoption of the project, make adjustments or stop the project. Therefore, the aim of reviewing is to ensure that there are benefits after the change that exceed the former practice.
Reporting
Documentation and filling of information is one of the most vital tasks in healthcare organization. The reports should be written by the people implementing the project and given to the relevant authorities. For example, the nurses affected by shift need to write a daily incidence report showing the day’s progress. Particularly, the nurse can note any complaints from the patients, delays in the handover, errors, changes made and their general evaluation of the transition process. The information is then compiled weakly and given to the nurse leader who can review for any inconsistencies. The reports are useful for seeing the progress of the initiatives proposed by the clinical team. Notably, the nurse leader has to compile reports from different teams and give them to the administrators so that they can determine the most profitable projects for the investments.
Confidentiality
The patients have a right to have their data regarding the diagnosis, treatment, management, medication and any other information protected from the public. First, the nurses understand that it is unethical and illegal to share data with those without authorized access. The project of bedside handover will further improve confidentiality in practice. For example, when the nurses are at the bedside handing over the patient data there is confidentiality. The patient gets to witness the handing over process and the reports or any oral information is completed by the outgoing nurse and given to the incoming one without any intermediaries. Moreover, there is no exchange of patient’s reports by many nurses, which makes it possible to trace the trace of breach. Thus, the nurses are more likely to maintain the privacy and confidentiality of the patients.
Conclusion
In conclusion, healthcare organizations have a commitment to ensure continuous quality improvement for their patients. The project of promoting bedside handover is needed since improper coordination and communication has negative implications, such as high rates of errors. Adopting the change requires participation and cooperation from all nurses, other staff, and the patient. The plans are all patient-centered and focused on enhancing the experience of the sick and their families at Genesis Corporation. It is vital to inform the workers earlier and train them to work, analyze incidences and write regular reports. With consistency and coordination, the change will be beneficial to the patients, and the reputation of the hospital will grow.
References
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Allah, N. A. (2022). Effectiveness of educational program on nurses’ knowledge and performance regarding shift change handoff and its effect on continuity of patient care. International Egyptian Journal of Nursing Sciences and Research, 3(1), 192-205.
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Forde, M. F., Coffey, A., & Hegarty, J. (2020). Bedside handover at the change of nursing shift: A mixed‐methods study. Journal of Clinical Nursing, 1(1), 1-27.
Hada, A., & Coyer, F. (2021). Shift‐to‐shift nursing handover interventions associated with improved inpatient outcomes—Falls, pressure injuries and medication administration errors: An integrative review. Nursing & Health Sciences, 23(2), 337-351.
Hada, A., Jones, L. V., Jack, L. C., & Coyer, F. (2021). Translating evidence‐based nursing clinical handover practice in an acute care setting: A quasi‐experimental study. Nursing & Health Sciences, 23(2), 466-476.
Larivee, H. (2019). Quality improvement in nursing. Web.