Strategic Interdisciplinary Approach to Enhancing Patient Outcomes- Implementing Leadership and Collaboration Best Practices for Organizational Improvement

Strategic Interdisciplinary Approach to Enhancing Patient Outcomes- Implementing Leadership and Collaboration Best Practices for Organizational Improvement

Introduction

This proposal plan attempts to solve the issue of increased incidences of ventilator-associated pneumonia (VAP) in the general ward unit. Ventilator-associated pneumonia develops within or more than forty-eight hours after patient admission (Martin-Loeches et al., 2018). It occurs in patients receiving mechanical ventilation. The plan will be carried out in the general ward unit of the hospital. Implementation of the plan will reduce the incidence of ventilator-associated pneumonia, shorten hospital stays, and improve patients’ quality of life.

Objective

The objective is to adopt evidence-based practices for patients receiving mechanical ventilation to reduce the incidences of ventilator-associated pneumonia. The evidence-based practices to be embraced include proper patient oral hygiene, continuous aspiration of subglottic secretions (CASS), minimizing proton pump inhibitors, placing patients in a semi-recumbent posture, and minimizing the duration of mechanical ventilation (Álvarez-Lerma et al., 2018). This objective is harmonious with the hospital’s broader goal of upholding quality patient-centered care to achieve better outcomes. Its success will ensure better outcomes by reducing the incidences of VAP.

Questions and Predictions

Will the implementation of evidence-based practices require more staff to be recruited?

The staff will not have to be increased during the initial implementation. However, when fully adopted, staff ratios, especially nurse ratios, will be optimized because of the increased workload created by evidence-based practices.

How will the interdisciplinary team minimize the duration of mechanical ventilation in this context?

All patients will be assessed to determine the necessity of mechanical ventilation. Those who fail to meet the inclusion criteria will not receive mechanical ventilation. Patients who receive mechanical ventilation will be monitored periodically. Once desirable ventilatory perfusion levels, mechanical ventilation will be discontinued.

What is the economic implication of the plan to the hospital and patients?

Initially, the hospital will be required to allocate extra funds to implement the plan. This will cater to activities such as training and purchasing CASS tubes. After the implementation, the hospital will benefit financially. A reduction in VAP will increase monetary reimbursements from the insurer who had slashed them. Patients will avoid extra treatment costs.

Change Theories and Leadership Strategies

Havelock’s change model will be used to create an interdisciplinary solution. This change model has six stages (Udod & Wagner, 2018). The first phase is pre-contemplation and relationship building, where the necessity for change is determined. The second phase is problem diagnosis, which involves determining the relevance and urgency of change (Udod & Wagner, 2018). The next phase is acquiring resources for change, which involves active research to create change. The next step is pathway selection, during which a specific facilitator of change is selected and implemented. The fifth phase is establishing and accepting the change (Udod & Wagner, 2018). The last phase is maintenance and separation, during which follow-up is conducted to ensure change is embraced into organizational culture.

This change theory will promote self-awareness and self-direction among interprofessional team members. It will enable them to recognize the clinical and economic impacts of ventilator-associated pneumonia (VAP), plan and research evidence-based preventive strategies, implement them and monitor their effectiveness. This change is beneficial to VAP because it will ensure that the best preventive evidence-based practices are adopted. Furthermore, the change theory will ensure that VAP incidences are significantly lowered due to the follow-up in the maintenance and separation phase.

The leadership strategy that will be used is appreciative inquiry. This strategy entails focusing on and reinforcing the strengths and achievements of team members (Folkman et al., 2019). In the context of this change plan, the abilities of each team member will be identified. Each plays a unique role in ensuring that VAP incidences are reduced. Reinforcing these abilities and knowledge will increase the willingness to collaborate, share knowledge and ensure that the plan is successful.

Team Collaboration Strategy

The interdisciplinary team involves nurses, physicians, pharmacists, and a representative from the hospital administration. Nurses, physicians, and pharmacists will select members among themselves to form a quality assurance team in charge of the project. The quality assurance team will be involved in the training of the other healthcare providers, conducting performance evaluations, and giving feedback. Furthermore, the quality assurance team will be responsible for rewarding the best-performing team members. The representative of the hospital administration will ensure that all financial costs are addressed. These include training costs and purchasing medical supplies such as CASS tubes and chlorhexidine mouthwash or gel for patient oral hygiene.

Physicians will assess patients and determine the need for mechanical ventilation. Nurses will ensure a semi-recumbent position of the patient, good oral hygiene, subglottic suctioning, intubating patients for mechanical ventilation, and monitoring their progress. Pharmacists will uphold rational medication use. An example is advising on the need to contraindicate proton pump inhibitors and ensure that the right concentrations of chlorhexidine mouthwash are available.

The collaborative strategy that will be used is open communication. Effective communication will help to inform team members about the goals and objectives (Folkman et al., 2019). In this context, specific evidence-based practices are being used to minimize VAP incidences. This will help avoid role ambiguity (Folkman et al., 2019). Through open communication, performance evaluation will be conducted, and feedback delivered. It will keep the team focused on fulfilling the goals and objectives. Open communication helps team members create a good rapport and increases their willingness to share information.

Required Organizational Resources

The first resource allocation should be channeled to staff training. The interdisciplinary team should be trained on the importance of collaboration, the health problem (VAP), and the skills needed to handle the problem. The second resource allocation should be on medical supplies. The plan aims to use evac-style endotracheal tubes to facilitate the continuous aspiration of subglottic secretions (CASS). Furthermore, it aims to improve hand hygiene and patients’ oral hygiene by using alcohol-based hand sanitizers and chlorhexidine mouthwash. Currently, the hospital does not have these medical supplies. Therefore, they should be purchased.

According to Single-Use Medical Equipment (n.d.), the cost of each evac-style endotracheal tube is approximately $1 to $5. The cost for acquiring approximately 300 endotracheal tubes would be about $1500. The monthly cost of purchasing hand sanitizers for healthcare providers is approximately $300. The monthly cost for purchasing a chlorhexidine mouthwash for the hospital is approximately $600. The cost of staff training will be approximately $800. The rewards for the best-performing team will be varied and will not always be monetary.

Failure to fully implement this plan has a negative financial implication for the organization. Currently, insurers have slashed reimbursements to the hospital because VAP is considered a preventable disease. Accordingly, this is likely to worsen if the plan is not implemented. Furthermore, VAP destroyed the hospital’s reputation. Patients are likely to choose other hospitals for their medical services. Ultimately, this has a negative financial implication for the hospital.

References

Álvarez-Lerma, F., Palomar-Martínez, M., Sánchez-García, M., Martínez-Alonso, M., Álvarez-Rodríguez, J., Lorente, L., Arias-Rivera, S., García, R., Gordo, F., Añón, J. M., Jam-Gatell, R., Vázquez-Calatayud, M., & Agra, Y. (2018). Prevention of Ventilator-Associated Pneumonia: The Multimodal Approach of the Spanish ICU “Pneumonia Zero” Program. Critical Care Medicine, 46(2), 181–188. https://doi.org/10.1097/CCM.0000000000002736

Folkman, A. K., Tveit, B., & Sverdrup, S. (2019). Leadership in Interprofessional Collaboration in Health Care. Journal of Multidisciplinary Healthcare, 12, 97–107. https://doi.org/10.2147/JMDH.S189199

Martin-Loeches, I., Rodriguez, A. H., & Torres, A. (2018). New Guidelines for Hospital-Acquired Pneumonia/ Ventilator-Associated Pneumonia: USA vs. Europe. Current Opinion in Critical Care, 24(5), 347–352. https://doi.org/10.1097/MCC.0000000000000535

Single-Use Medical Equipment (n.d.). Single Use Medical Equipment PVC Reinforced Endotracheal Tube Size 2.5-10 mm. https://www.made-in-china.com/products-search/hot-china-products/Reinforced_Endotracheal_Tube.html

Udod, S., & Wagner, J. (2018). Common Change Theories and Application to Different Nursing Situations. https://opentextbooks.uregina.ca/leadershipandinfluencingchangeinnursing/chapter/chapter-9-common-change-theories-and-application-to-different-nursing-situations/

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For this assessment, use the context of the organization where you conducted your interview to develop a viable plan for an interdisciplinary team to address your identified issue. Based on the information gathered in your interview, define a specific patient or organizational outcome or objective.

Strategic Interdisciplinary Approach to Enhancing Patient Outcomes- Implementing Leadership and Collaboration Best Practices for Organizational Improvement

This assessment aims to clearly lay out the improvement objective for your planned interdisciplinary intervention of the issue you identified. Additionally, be sure to build on the leadership, change, and collaboration research you completed in the previous assessment. Look for specific, real-world ways in which those strategies and best practices could be applied to encourage buy-in for the plan or facilitate the implementation of the plan for the best possible outcome.

Using the Interdisciplinary Plan Proposal Template [DOCX] will help you stay organized and concise. As you complete each section of the template, make sure you apply APA format to in-text citations for the evidence and best practices that inform your plan, as well as the reference list at the end.

Additionally, be sure that your plan addresses the following, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so you understand what is needed for a distinguished score.

Describe an objective and predictions for an evidence-based interdisciplinary plan to achieve a specific goal related to improving patient or organizational outcomes.
Explain a change theory and a leadership strategy supported by relevant evidence that is most likely to help an interdisciplinary team succeed in collaborating and implementing, or creating buy-in for, the project plan.
Explain the collaboration needed by an interdisciplinary team to improve the likelihood of achieving the plan’s objective. Include best practices of interdisciplinary collaboration from the literature.
Explain organizational resources, including a financial budget, needed for the plan to succeed and the impacts on those resources if the improvements described in the plan are not made.
Communicate the interdisciplinary plan, with writing that is clear, logically organized, and professional, with correct grammar and spelling, using current APA style.