Leadership Strategy Analysis - mynursingprofessionalportfolio



Leadership Strategy AnalysisMaggie SilerFerris State UniversityAbstractThe purpose of this paper is to analyze the importance of nursing leadership in quality improvement initiatives such as the ST Elevated Myocardial Infarction (STEMI) Performance Improvement Team. It is of crucial importance that STEMI patients receive timely care to improve outcomes, and ultimately reduce long term health care costs. The STEMI task force is composed of administrators, nurses, corporate communications personnel, physicians, emergency medical technicians (EMT’s), and emergency room technicians. Working cooperatively toward the common goal of reducing time from diagnosis to definitive care for the STEMI patient involves effective collaboration and communication among many disciplines, including the general public. The focus of this paper is analyzing public education efforts regarding the risk factors for, and symptoms of myocardial infarction, with emphasis on how to best seek care. This is accomplished through nursing leadership in health promotion by the work of the multidisciplinary STEMI Public Education committee. Leadership Strategy AnalysisMyocardial infarction and stroke are the leading causes of death in the United States today (Lambert, Vinson, Shofer, & Brice, 2012). It is vitally important to further engage the public with knowledge of the risks for, and symptoms of myocardial infarction/stroke. Creating an affordable, effective public education program requires the collaboration of a diverse group of like-minded individuals. Strong nursing leadership in quality improvement initiatives such as health promotion for the general public is essential. Nurses are the front line of care and often have an in-depth understanding of the needs of the population they serve. The following paper will examine and analyze the work of the Northwestern Regional STEMI Public Education Committee. Educational strategies, goals, and evaluation methods will be examined.BackgroundMunson Medical Centers Regional STEMI Initiative (Munson Healthcare, 2010) has been dedicated to improving outcomes for all STEMI patients since July 2009. The work of the regional committee is directed by national guidelines and benchmarks set by the American Heart Association’s Mission: Lifeline (American Heart Association, 2011). Since inception, the committee has made great strides toward improving the delivery of timely care and patient outcomes. Each STEMI case is individually reviewed and areas which require improvement are addressed in an ongoing manner. The Centers for Medicare/Medicaid (CMS) has established a measurable set of indicators which are documented and measured for each myocardial infarction or stroke patient throughout their hospitalization. Utilization of these indicators helps ensure the most current evidence based care for each patient (Leeper, Cyr, Lambert, & Martin, 2011). . Engaging the general public through increased awareness of the risks for and symptoms of vascular disease will add to the progress of this quality improvement initiative. Clinical NeedIt has been evidenced that public knowledge regarding the risks for, as well as the signs and symptoms of heart attack/stroke, and how to best seek care is alarmingly low (Elliott, 2008). Evidence also demonstrates the earlier these patients receive care, the better their outcomes. On analysis of data obtained by the STEMI committee, it was found that patients increasingly used 911/EMS to access care following times of increased public educational efforts (Fox, 2012). Therefore, this is an evidence based project, and the author has taken the leadership role of STEMI Public Education chairperson. This nursing leadership endeavor will further engage the general public in self-care related to myocardial infarction and stroke. A multidisciplinary team has been formed to address improving public understanding of the risks for and symptoms of cardiac/vascular disease, as well as the importance of activating the Emergency Medical System (EMS) to reduce time to definitive care, and further improve outcomes. The goal of this public education committee is to improve patient accountability to outcomes and provide more efficient use of our healthcare dollars. Multidisciplinary TeamPublic education is a crucial part of every nurse’s daily work. In a far reaching effort, a multidisciplinary team is an effective method with which to approach any area of general public education. Every professional involved brings a broad base of perspective and knowledge to add depth and interest to the educational program(s) (Olson, Tooman, & Alvarado, 2010). Below listed, please find a description of each collaborative STEMI Public Education committee team member, including analysis of individual roles and contributions.Hospital AdministrationWithout the support of hospital administration, no program/effort can survive. All care today must be evidence based, both for the patients as well as the institutions benefit (Leeper et al., 2011). All programs must be evidence based, cost effective and provided in a timely manner to ensure administrative support. The STEMI public education committee has garnered financial support from hospital administration to produce educational materials for use in various venues. Corporate Communications PersonnelInstitutionally based corporate communication departments are very sensitive to the needs of the community involved. They create the face of the institution. If one is working on an evidence based program in a hospital environment today, the support of hospital based public relations is almost always assured. Many institutions are able to produce institutionally “branded”educational material to further draw public interest and increase awareness and engagement. Media campaigns can be both effective and expensive (Pender, Murdaugh, & Parsons, 2011, p. 252). In proper settings including; health fairs, local festivals, and schools, a good deal of the general public can receive life-saving information in a cost effective manner.EMS/Emergency Medical TechniciansEMT’s are invaluable, especially in a rural area such as northwestern Lower Michigan. In MI and stroke, time is of the essence. Efficiency is crucial, every minute counts toward improving outcomes (AHRQ Research Activities, 2011). Early electrocardiograms, IV access, and medications go a long way in the treatment of STEMI/stroke patients. Evidence states, if the general public activates EMS in a timely manner, better outcomes will ensue and the healthcare bottom line will improve. This is especially true in rural northern Michigan, where knowledge deficits may be greater (Swanoski, Lutfiyya, Amaro, Akers, & Huot, 2012). EMT participation will emphasize the importance of calling 911. Emergency Room TechnicianPersonnel in this setting are crucial to expediting care with early electrocardiograms, and lab work when a patient presents with cardiac/neurological symptoms (AHRQ Research Activities, 2011).NursesNurses are the glue that holds the healthcare system together. They have an in depth understanding of the needs of the population they serve. Nurses are also expert at multidisciplinary collaboration, and quality communication. Patient education is a natural part of the work of nurses. It is well suited that nursing take a leadership role in a vital educational program such as this (Yoder-Wise, 2011, p. 452). Physicians/CardiologistsPhysicians direct the care of every STEMI/stroke patient and are increasingly held accountable to following evidence based guidelines to improve outcomes and decrease healthcare costs (Leeper et al., 2011). The authority and encouragement they offer help inspire the work of the committee. Data Collection MethodThe regional STEMI initiative currently evaluates a number of evidence based measures established by the American Heart Association and the American College of Cardiology (Leeper et al., 2011) to compare the regional system of care to national data. Included in the metrics are; percentages of patients accessing care through EMS, and the time from symptom onset to arrival at the hospital (Fox, 2012). Both measures are applicable to evaluating the impact of increasing public education efforts. If the general public has greater symptom awareness, a reduction in time from symptom onset to arrival at the hospital should be observed. Success of the ongoing educational program can also be measured by an increase in activation of EMS for MI/stroke symptoms. These measures must be routinely evaluated and changes to the program can be implemented according to the evidence observed. It would also provide beneficial feedback to provide attendees at educational sessions with evaluation forms to further fine tune efforts.Anticipated OutcomesThere are many varied and far reaching benefits to public education efforts. This is especially true in areas crucial to health promotion. With heart disease as the leading cause of death in the United States, nothing but good can come from increasing the general public’s understanding of the risks for and symptoms for cardiovascular disease. Decreased morbidity and mortality, as well as primary and secondary prevention of cardiovascular disease are the main goals of this quality improvement initiative. There is a dearth of public awareness of the risks of diabetes, overweight, smoking, hypertension, and hyperlipidemia as related to cardiovascular disease (Elliott, 2008). Increasing the public’s knowledge base is the first step toward improving individual accountability. Increased personal accountability will lead to improved public health and decreased costs to the already over-burdened health care system. Observing measurable improvements in patient outcomes is an additional benefit (Leeper et al., 2011) that would be experienced with a successful public education program. Making this program community focused and low cost through volunteer efforts will be further advantages. Implementation StrategiesAn important characteristic of nursing leadership in health promotion efforts is utilization of current theory. Nursing theory helps answer questions, supports evidence based care and management styles, as well as guiding clinical and organizational issue resolution (Yoder-Wise, 2011, p. 7). The Integrated Theory of Health Behavior Change (ITHBC) (Polly, 2009) was used as the basis for this public education program. This theory is based on enhancing knowledge and beliefs, as well as improving self-regulation skills, and augmenting social support toward lasting changes. With this theory in mind, evidence based, institutionally branded educational materials are currently being developed. The focus of this material includes the risk factors for, and symptoms of cardiovascular disease, as well as the importance of activating 911 for those symptoms. These materials will be made available at various community events such as health expos, local events/festivals, and various service groups. Volunteers from the education committee will be present at the various venues to provide education. Many family members attend these venues and can be appropriate social support for this important educational undertaking. With the right material, popular venues, and a bit of volunteer time, an inexpensive and effective public educational program can be undertaken. EvaluationThe importance of public health promotion regarding early recognition of cardiovascular symptoms and timely receipt of care, including secondary prevention (risk factor management), is crucial to reducing mortality related to myocardial infarction (Leeper et al., 2011). It has been established that increasing public education efforts improves outcomes both locally as well as nationally (Fox, 2012). Evaluating regional STEMI data regarding symptom recognition (time to seeking care), as well as method for seeking care (personal vehicle or EMS) after increased educational efforts will analyze the effect of this educational program (Leeper et al., 2011). Following evaluation, theory/evidence based educational programs will be reviewed and modified/expanded based on the results of the measured data (Polly, 2009). That is the science of nursing. ScholarshipNursing theory focuses assessments, directs interventions supporting change, and improves outcomes (Polly, 2009, p. 161). It also cultivates collaborative communication with other disciplines (Polly, 2009). General public health promotion related to cardiovascular disease as the leading cause of death in the United States is vital. Theory is the essence of evidence based health care. Use of theory is vital for every healthcare professional, and is of the utmost importance to nurses, as they are the touchstone for all aspects of healthcare. A public education program (based on nursing theory) regarding the risks for, symptoms of, and best method to seek care for cardiovascular events can greatly impact patient outcomes and healthcare costs. In conclusion, nurses have their “fingers on the pulse” of the population they serve, and are best suited to coordinate general public health promotion efforts. Nursing theory and evidenced based care provide solid ground to form public educational programs on. Programs can be revised based on the evidence/measured data compared to national benchmarks. If even modest improvements are met with better outcomes/lower costs, measurable success will be had. ReferencesAHRQ Research Activities. (2011). Heart attack victims should use emergency transport services, not self or family to get to the hospital. AHRQ Research Activities, 374. Retrieved from &db=cin20 &AN=2011313622&site=ehost-liveAmerican Heart Association. (2011). , V. S. (2008). Poor awareness of cardiac, stroke symptoms can delay care. Retrieved from , J. M. (2012, July). Northern Michigan Regional STEMI System of Care. Paper presented at the Munson Medical Center, Traverse City, MI.Lambert, C., Vinson, S., Shofer, F., & Brice, J. (2012, March 10). The relationship between knowledge and risk for heart attack and stroke. Stroke . Retrieved from , B., Cyr, A., Lambert, C., & Martin, K. (2011, Dec 23). Acute coronary syndrome. Critical Care Nurse, 4, 547-557. Retrieved from Healthcare. (2010). , C. A., Tooman, T. R., & Alvarado, C. J. (2010). Knowledge systems, healthcare teams, and clinical practice: a study of successful change [Entire issue]. Advances in Health Sciences Education : Theory and Practice, 15(4). , N., Murdaugh, C., & Parsons, M. (2011). Health promotion in nursing parctice (6th ed.). Upper Saddle River, NJ: Pearson Education, Inc.Polly, R. (2009, May/June). Integrated theory of health behavior change: background and intervention development. Clinical Nurse Specialist, 23(3), 161-170. , M. T., Lutfiyya, M. N., Amaro, M. L., Akers, M. F., & Huot, K. L. (2012, June 1). Knowledge of heart attack and stroke symptomology: a cross sectional comparison of rural and nonrural US adults. BioMed Central Public Health, 12. doi:10.1186/1471-2458-12-283Yoder-Wise, P. (2011). Leading and managing in nursing (5th ed.). St. Louis, MO: Elsevier Mosby. ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download