Analyzing a Leader - Jessica's Nursing Portfolio



Analyzing a LeaderJessica HouseFerris State UniversityAnalyzing a LeaderThe importance of good leadership and the qualities needed to effectively lead is a heavily researched topic and mastery of this is vital to our success in healthcare. The purpose of this paper is to analyze the role of DG, a Patient Safety Specialist at Covenant Healthcare.? Her leadership role is of utmost importance as a representative and defender of patient safety. This paper will analyze her leadership role, and it will breakdown the many facets of what is required for a successful leader in an organization, and what impact can be made if the requirements of this role are fulfilled.BackgroundDG attended Delta College and received her degree as a Surgical Technologist and began her career in the operating room. She then went on to obtain her Bachelors in Business Administration Healthcare Management graduating the top of her class as a valedictorian with a 4.0 GPA from Northwood University.?? While working in the OR she was asked to be the interim educator requiring many of the skills sets found in a good leader.? She needed to network with and represent staff, effectively communicate with her leadership the issues and challenges she observed, and then communicate back to the front line staff any new changes, policies, or new processes being implemented in the OR.? This became a favored position for DG where she flourished in the environment of connecting with co-workers and also advocating for them, while simultaneously showing respect and open mindedness in her interactions with leadership and executives within her organization.? An unfortunate injury disabling her left arm led her ultimately to the Quality Department and a whole new world of patient advocacy.? From there her leadership skills continued to grow as she took on a major role of data collection and process improvement. ?Her official job title was “Quality Improvement Specialist” but she always wore more hats than what was written in her job description.? She was assigned the role of data collection for the Michigan Surgical Quality Collaborative, a Blue Cross Blue Shield CQI collaborative quality initiative.? Blue Cross funded many of these positions across the state of Michigan with the purpose of data collection and promotion of process improvement and quality for patients based on data collected in the consortium.? DG felt driven to take this data she was collecting and invoke positive change in her organization with several process improvement projects more than required for this role.? Currently she is a Patient Safety Specialist, leading teams for process anizational StructureAccording to DG the organizational structure and philosophy can be described as a compact between the Covenant medical Staff and the entire Covenant HealthCare System with a shared vision of driving extraordinary care for patients and communities. Covenant is on a journey towards becoming a High Reliability Organization (HRO) “requiring a collective mindfulness and acute awareness that even small failures in safety processes or behaviors can lead to serious adverse outcomes for patients” ("Covenant HealthCare," 2016, para. 1). DG falls under the Quality arm of the organizational grid. The organization structure can best be described as a functional structure with departments and services arranged according to specialty (Yoder-Wise, 2015, p. 145). She reports to the Safety officer, who reports to the Chief Transformation Officer, who then reports directly to the CEO of the organization. DG oversees the Partnership for a Better Recovery Program and the nurse educator and central scheduler assigned to this program.AONE Nurse Manager CompetenciesThe AONE Nurse Manager Competencies are based on the Nurse Manager Learning Domain Framework (Sherman & Pross, 2010, figure 1). The three components are the Science of managing the business, the art of leading people, and the leader within: creating the leader in yourself. This Framework captures the skills, knowledge and abilities that guide the practice of nurse leaders and in order to be a successful leader, expertise is required in all 3 domains ("American Organization of Nurse Executives," 2015, p. 3). This framework was shared with DG during the interview and its components were reviewed and reflected upon. While analyzing the work performed by DG, many skillsets are reinforced by the AONE and will be further examined based on the leadership skills displayed by DG throughout her career.The Science of Managing the BusinessHuman Resource ManagementAccording to the AONE nurse manager competencies, Human Resource Management describes the staffing needs, staff selection and orientation of employees. DG was very active and led interview panels and also helped to develop orientation programs both in the OR and in the Quality department. She recognized the importance of hiring staff with certain skill sets and work ethic, and found it the utmost priority to welcome new employees and setting them up for success. Staff felt more empowered with their increased knowledge to perform their job with confidence in their abilities. The organizational environment encouraged individuals to employ the freedom of making decisions while retaining accountability for the consequences of those decisions” (Yoder-Wise, 2015, p. 284). Part of this new employee orientation DG developed the creation of an education room for people working in the operating room. The room was equipped with videos, reference manuals, computers, policies and procedures and anything a new employee including physicians could need in the OR. To ensure each employee’s orientation was successful, she also created an orientation evaluation to evaluate the effectiveness of the orientation. Staff voiced gratitude and positive feedback with the changes made to the orientation process and it became a staff satisfier, which also helped with nursing and OR employee retention and morale. “Effective appropriate training has a measurable impact on reducing turnover as does complete effective new employee orientation (Yoder-Wise, 2015, p. 283)Performance ImprovementAnother major success was the development of the Partnership for a Better Recovery Program.? Realizing based on the data she collected through the MSQC an opportunity existed for better education for patients scheduled for surgery.? Oftentimes education provided to patients before they have surgery is lacking in quality, leaving patients feeling unprepared. ? Several negative outcomes were identified as occurring with surgical patients such as pneumonia, readmission, poor pain control, constipation and bowel obstruction, dehydration, blood clots, surgical site infections and MI’s. ? DG wanted to help those patients be more prepared for their surgeries but also wanted to improve their outcomes as well. So she created a program to help educate on ways to prevent pneumonia and infection and be more successful in managing their pain, controlling their blood sugars, maintaining good hand hygiene and protecting their surgical incision.? It was also a great opportunity for patients to ask questions and help connect them with resources in the community such as transportation, Cpap machines/sleep studies and blood sugar diabetes education. ? ?For this program DG managed a budget for supplies, oversaw the scheduler assigned to this project along with an RN assigned to teach the seminars and was the administrator over this project.? She also worked with business development to design and create the 10-page brochure, and worked with EPIC to create all the documentation needed for the program in the EMR.? The program was a huge success and a patient satisfier.? Patients felt more prepared for their surgery and were very happy the hospital offered a free program to help them and expressed their gratitude in many heart-felt letters of appreciation. Data was collected to monitor outcomes of this program and showed notable improvements in patient recovery following surgery, along with a reduction in post-op complications.Strategic ManagementDue to her ability to juggle many big tasks simultaneously with successful outcomes, DG was also given the role HFAP and state survey coordinator.? This task involved months of planning to make sure all the HFAP manuals held the most current up to date information regarding staff specific policies and procedures for each unit in the hospital.? Part of preparation included ensuring each unit was ready and able to demonstrate the work being done on safety events and process improvement projects. This also included holding other managers accountable to making sure staff members were knowledgeable about where to find the Material Safety Data Sheets Manual or (MSDS manual) with reference as to what you would do if there were a fire, and to make sure staff was knowledgeable about environmental safety in the organization.? When surveyors arrived, DG coordinated the scribes assigned to the surveyors, the scouts assigned to the units to ensure their environment was HFAP ready, while simultaneously communicating and coordinating with the surveyors directly in a timely basis.?? DG displayed leadership qualities by exemplifying professionalism and collaborating well with others during a very tense stressful situation. Collaborating is both assertive and cooperative and when done properly, individuals can carefully analyze situations to identify the nature and reasons for conflict and choose an appropriate approach (Yoder-Wise, 2015, p. 440). Fortunately, the HFAP survey was very successful, and the team worked very well together with the leadership of DG.Financial ManagementRecognizing the impact of reimbursement on revenue, DG worked hard to ensure improvement was made in the CQI Blue Cross Collaborative she led. This Collaborative reimbursed her organization based on performance metrics that were analyzed quarterly. ? Each year her organization would receive $250,000 if all outcomes were met, and she consistently met them over the 6 years she participated in the program. In today’s value-based purchasing environment and reimbursement methodology, nurses need to understand their organizations’ reimbursement environment, identify how they can influence patient outcomes such as hospital-acquired conditions (HACS), and strategy for realizing a profit in its specific circumstances (Yoder-Wise, 2015, p. 218).The Art: Leading the PeopleHuman Resource Leadership Skills“The art of leadership involves managing relationships with others and influencing their behaviors” (Sherman & Pross, 2010, para. 18). The primary focus of DG’s role as Patient Safety Specialist within the Quality was leading the investigations and the subsequent process improvement teams following any safety events that occurred within the organization.? Once an event was identified as a possible safety event, it was reviewed by DG and formerly written up and went to a serious safety event rating committee comprised of directors, executives, physicians, and DG. From here the event was rated and the rating committee determined next steps, and a champion is then assigned.? The case may go for peer review (reviewed by a physician), department level review, or a root cause analysis team where further investigation included those directly involved in the event.? “Guiding team members to get past their day-to-day problems, conflicts, and communications issues and more toward a goal of working as a high performance work team is a significant leadership challenge for emerging leaders (Sherman & Pross, 2010, para. 16). I had the pleasure of witnessing many teams driven with DG’s assertive, respectful, and organized approach. Many team members voiced appreciation for the respect shown for their valuable time, and the swift resolution and positive outcomes resulting from the team’s hard work. Team members also voiced appreciation for DG’s effective methods for communication and excellent follow through. Relationships live within the context of conversations that individuals have, or don’t have, with one another and excellent communication is a fundamental skill needed to effectively lead others (Sherman & Pross, 2010, para. 16). Following these investigations, her role also included communicating literature-based ideas regarding effective patient safety strategies to others within the organization to help avoid this event from occurring again. Relationship Management?and Influencing BehaviorsAnother self-driven project led by DG was the upper extremity VTE prevention initiative. Recognizing that a concerning amount of patients with PICC lines developed an upper extremity blood clot or VTE (Venous Thromboembolism), together with help from a multidisciplinary team, work was started to determine ways of improving outcomes for patients in her organization. Together with the PICC team nurses, educators, PT and OT, managers, Directors, and front line staff she led a very successful program with a decrease in upper extremity VTE’s.? DGs methods of collaboration and empowerment, created an atmosphere of positive teamwork and a healthy work environment. “The AACN noted that recognition of the value and meaningfulness of one’s contribution to an organization’s work is a fundamental need and important for both professional and personal development” (Sherman & Pross, 2010, para. 22). Through her leadership she was able to obtain a?grant for the purchase of new mannequin arms and chests for purposes of education. Staff was educated on insertion of peripheral IV’s to decrease PICC line usage, using methods like increasing ROM exercises, using smaller lumens for PICC lines, and monitoring PICC line assessment charting as strategies to provide better care and delivery for these patients.? She also observed the usage of Cathflo, which is a medication that will eliminate a clot as it develops on the end of a PICC line and the culprit for the eventual development of a blood clot large enough to occlude blood flow that extremity. Together with her team, they celebrated the success of the project with a subsequent decrease in blood clots identified in her organization. She later went on to present this initiative at her MSQC conference later that year. DG displayed attributes of transformational leadership by motivating employees by articulating her inspirational vision; encouraging novel and innovative thinking, and by giving the employees individualized consideration based on their needs and abilities (Yoder-Wise, 2015, p. 38).The Leader WithinPersonal and Professional AccountabilityDG is a very driven and committed individual that continually seeks educational opportunities and strives to continually improve herself and the organization as well. Careful consideration is given to every performance review with the understanding that goals help her to know what she planned for was actually accomplished. Currently DG has her Bachelors in Business Administration Healthcare Management and has aspirations for continued growth and challenge.? “With drive and ambition you can continue to improve skills, and this is the only way to make you a better person as a team leader and as a professional” she states. ?DG continues to be involved in associations, and aspires to be certified in patient safety through a national certification in Patient Safety and Quality.? According to DG, “Having that licensure shows to yourself and others that you have the qualifications that you can perform the job you are doing and it helps to hold you accountable to your own expectations.” ?ConclusionDG is a remarkable individual, and a driven, tenacious and respectable leader. Having the opportunity to interview her not only was a wonderful way to reflect upon the accomplishments of DG, but it provided an inspiring example of the great results that hard work and dedication can bring. DG’s commitment to improving the quality of care and promotion of a culture of safety for patients in her organization is recognized and respected. Her ability to drive change by collaboration and empowering her team, and creating a healthy work environment has a positive impact on staff satisfaction, improved patient outcomes, and organizational performance (Sherman & Pross, 2010, para. 1). I feel strongly that her work has helped countless patients, the ripple effect of her hard work will be seen for years to come, and her passion for change is inspiring and epitomizes the very definition of a great leader.ReferencesAONE Nurse Manager Competencies. (2015). Retrieved November 1, 2016, from , vision and values. (2016). Retrieved November 1, 2016, from , R., & Pross, E. (2010, January 31). Growing furture nurse leaders to buiild and sustain health work environments at the unit level. OJIN: The Online Journal of Issues in Nursing, 15. , P. S. (2015). Leading and managing in nursing (6th ed.). St. Louis, MO: Mosby ................
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