Interview and Interdisciplinary Issue Identification

Interview and Interdisciplinary Issue Identification

I interviewed my Director of Nursing, Alicia Holman, at Hospice. Hospice is a company that strives to stand out from other hospice companies by providing the highest quality of care to its patients, families, and referring sources. They do this by utilizing and maximizing their strongest assets: their employees. Alicia’s role in the company is to ensure all her nurses are educated and well-supported by leadership within the company. She is also ensuring her entire team of nurses, physicians, CANs, spiritual care coordinators, social workers, community liaisons, and volunteers are caring for every patient within the Medicare guidelines.

During my interview with Alicia, I asked her to describe a current or past issue in her organization. She told me about a recent issue that affected her admissions nurses. Her admissions nurses were feeling overwhelmed and overworked due to the lack of organized communication between the nurses and her team of community liaisons as well as her team of physicians. When a liaison has a family agree to be evaluated by a nurse to assess the appropriateness of hospice care, the liaisons will schedule a visit by a nurse, even before checking with the nurse about appointments. That would cause nurses to either be late for appointments or have to reschedule even after a time was promised. That would make the company’s customer service look unprofessional. Another problem was that there was a delay in communication with physicians which caused a lot of wasted time on not just the nurses’ part, but the patient and family as well. In order to admit a patient, a nurse has to evaluate them and give a report to the physician in order to approve or deny admission into the hospice program. If there is no timely response, the nurse cannot touch the patient to do a full assessment, and no consent forms can be signed for admission.

This lack of communication caused a rift between the nurse and their liaisons and doctors. The nurses ended up working 10 to 14-hour days, 5 days a week. The company encourages overtime for their nurses to complete their charting within 24-48 hours of admissions (per Medicare guidelines). However, they were starting to feel the overwhelming stress of meeting those timelines. As a leader the nurses can turn to, Alicia was helping them with the charting, like inputting diagnoses and medication lists, but that was all she could help them with. Assessments had to be done by the nurse who assessed the patient. Unfortunately, due to having to meet patient after patient and having to wait for doctors to respond, there was very little time left to chart each patient, thus why they were working such long hours. Due to this high level of stress, the nurses started to feel a lot of animosity toward those teams.

Alicia knew something had to be done. In order to solve this problem, she needed to hold an interdisciplinary team (IDT) meeting. In that meeting, the nurses, physicians, and community liaisons needed to find a resolution to the communication issues at hand. Alicia believes all employees at Hospice are always willing to come together to find solutions to problems. In this case, teams had to figure out what their problems were, what their goals were, and how to find a medium in which they could all achieve their goals while supporting one another.

Issue Identification

The issue Alicia was having was an interdisciplinary issue. Three different teams of nurses, physicians, and community liaisons had to find a way to work together to communicate and find a solution in which the nurse wouldn’t feel so overwhelmed and overworked. “Open communication, management support, professional suitability, mutual learning, and teamwork” (Garcia et al. 2019) are ways the three different teams could come together to find a mutual solution where everyone can meet the mutual goal of helping patients. Ultimately the problem at hand was a timing issue for the nurses. When considering the physicians, their problem was that they were with patients of their own while the nurses were trying to contact them. Physicians could not interrupt their services with the patient in front of them so that they could respond to the nurses. The community liaisons were having trouble from a business aspect. As a business, Hospice requires admissions of patients so that the business can keep growing. The community liaisons try to meet a goal every month to refer and help admit a certain number of patients. Thus, why is there a rush in trying to get an admissions nurse to see the patients they refer? An interdisciplinary approach is necessary to find a solution to this problem.

Change Theories That Could Lead to an Interdisciplinary Solution

Kurt Lewin’s theory of change states, “An action research approach involves analyzing the current situation of an organization, identifying the range of possible change solutions, and choosing the one that is most appropriate” (Batras, Duff, and Smith 2016). His theory is relevant because it is exactly how Alicia approached the problem. The teams came together in a meeting to analyze their situations, identify the problems, and brainstorm possible and most appropriate ways to solve their problems. Coming together as one big team to find a solution ultimately helps the patients.

Leadership Strategies That Could Lead to an Interdisciplinary Solution

As the Director of Nursing, Alicia isn’t just her nurses’ boss, but she is someone everyone can turn to when there is a problem; she is one to lend a hand where she can, and she will support her staff members in every way she can. “Leaders are not just the individuals in positions of leadership. Rather, they are the ”go-to” individuals who can be counted on, who are approachable, and who have developed and used their leadership strategies effectively” (Menaker 2016). This quote reigns true about Alicia. Alicia is an example of a leader her nurses were able to turn to for support and guidance during this difficult situation. She understood her nurses were having difficulty but also recognized it was not just a one-sided problem. She was able to bring the teams together to find a resolution that would benefit everyone and help patients at the same time.

Collaboration Approaches for Interdisciplinary Teams

An interdisciplinary approach would be appropriate for this situation because three different disciplinary teams are trying to find a solution where they can work together. “Interprofessional implies that different professions work together to provide integrated and cohesive products or services” (Nandan et al.2017). When these teams work together, they can provide the best care for all their patients.

Hospice is an organization that consists of many different disciplinary teams that come together to meet a common goal: providing the best end-of-life care for their patients. The team of nurses, physicians, and community liaisons collaborated together to find a solution that would work for everyone so that the organization could continue to provide the best care for their patients.

References

Batras, D., Duff, C., & Smith, B. J. (2016;2014;). Organizational change theory: Implications for health promotion practice. Health Promotion International, 31(1), 231. doi:10.1093/heapro/dau098

Menaker, R. (2016). Leadership strategies: Achieving personal and professional success. The Journal of Medical Practice Management: MPM, 31(6), 336.

Varagona, L., Nandan, M., Hooks, D., Porter, K. J., Maguire, M. B., & Slater-Moody, J. (2017). A model to guide the evolution of a multi-professional group into an interprofessional team.Journal of Faculty Development, 31(2), 49.

Garcia, C., Abreu, L., Ramos, J., Castro, C., Smiderle, F., Santos, & J., Bezerra, I. (2019, September). Influence of Burnout on Patient Safety: Systematic Review and Meta-analysis. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6780563/

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For this assessment, you will create a 2-4 page report on an interview you have conducted with a health care professional. You will identify an issue from the interview that could be improved with an interdisciplinary approach and review best practices and evidence to address the issue.

As a baccalaureate-prepared nurse, your participation and leadership in interdisciplinary teams will be vital to the health outcomes of your patients and organization. One way to approach designing an improvement project is to use the Plan-Do-Study-Act (PDSA) cycle. The Institute for Healthcare Improvement describes it thus:

Interview and Interdisciplinary Issue Identification

The Plan-Do-Study-Act (PDSA) cycle is shorthand for testing a change in the real work setting—by planning it, trying it, observing the results, and acting on what is learned. This is the scientific method adapted for action-oriented learning…Essentially, the PDSA cycle helps you test out change ideas on a smaller scale before evaluating the results and making adjustments before potentially launching into a somewhat larger-scale project (n.d.).

You might also recognize that the PDSA cycle resembles the nursing process. The benefit of gaining experience with this model of project design is that it provides nurses with an opportunity to ideate and lead improvements. For this assessment, you will not be implementing all of the PDSA cycles. Instead, you are being asked to interview a healthcare professional of your choice to determine what kind of interdisciplinary problem he or she is experiencing or has experienced in the workplace. This interview, in Assessment 2, will inform the research that you will conduct to propose a plan for interdisciplinary collaboration in Assessment 3.

It would be an excellent choice to complete the PDSA Cycle activity prior to developing the report. The activity consists of four questions that create the opportunity to check your understanding of best practices related to each stage of the PDSA cycle. The information gained from completing this formative will promote your success with the Interview and Interdisciplinary Issue Identification report. This will take just a few minutes of your time and is not graded.

Reference
Institute for Healthcare Improvement. (n.d.). How to improve. http://www.ihi.org/resources/Pages/HowtoImprove/default.aspx

Demonstration of Proficiency
Competency 2: Explain how interdisciplinary collaboration can be used to achieve desired patient and system outcomes.
Summarize an interview focused on past or current issues at a healthcare organization.
Describe collaboration approaches from the literature that could be relevant in establishing or improving an interdisciplinary team to address an organizational issue.
Competency 3: Describe ways to incorporate evidence-based practice within an interdisciplinary team.
Identify an issue from an interview for which an evidence-based interdisciplinary approach would be appropriate.
Competency 4: Explain how change management theories and leadership strategies can enable interdisciplinary teams to achieve specific organizational goals.
Describe change theories and a leadership strategy that could help develop an interdisciplinary solution to an organizational issue.
Competency 5: Apply professional, scholarly, evidence-based communication strategies to impact patient, interdisciplinary team, and systems outcomes.
Organize content so ideas flow logically with smooth transitions; contain few errors in grammar/punctuation, word choice, and spelling.
Apply APA formatting to in-text citations and references, exhibiting nearly flawless adherence to APA format.
Professional Context
This assessment will introduce the Plan-Do-Study-Act (PDSA) Model to create change in an organization. By interviewing a colleague of your choice, you will begin gathering information about an interprofessional collaboration problem that your colleague is experiencing or has experienced. You will identify a change theory and leadership strategies to help solve this problem.

Scenario
This assessment is the first of three related assessments in which you will gather interview information (Assessment 2); design a proposal for interdisciplinary problem-solving (Assessment 3), and report on how an interdisciplinary improvement plan could be implemented in a place of practice (Assessment 4). At the end of the course, your interviewee will have a proposal plan based on the PDSA cycle that he or she could present to stakeholders to address an interdisciplinary problem in the workplace.

For this assessment, you will need to interview a healthcare professional such as a fellow learner, nursing colleague, administrator, business partner, or another appropriate person who could provide you with sufficient information regarding an organizational problem that he or she is experiencing or has experienced, or an area where they are seeking improvements. Consult the Interview Guide [DOCX] for an outline of how to prepare and the types of information you will need to complete this project successfully.

Remember: this is just the first in a series of three assessments.

Instructions
For this assessment, you will report on the information that you collected in your interview, analyze the interview data, and identify a past or current issue that would benefit from an interdisciplinary approach. This could be an issue that has not been addressed by an interdisciplinary approach or one that could benefit from improvements related to the interdisciplinary approach currently being used. You will discuss the interview strategy that you used to collect information. Your interview strategy should be supported by citations from the literature. Additionally, you will start laying the foundation for your Interdisciplinary Plan Proposal (Assessment 3) by researching potential change theories, leadership strategies, and collaborative approaches that could be relevant to the issue you have identified. Please be certain to review the scoring guide to confirm specific required elements of this assessment. Note that there are differences between basic, proficient, and distinguished scores.

When submitting your plan, use the Interview and Issue Identification Template [DOCX], which will help you to stay organized and concise. As you complete the template, make sure you use APA format for in-text citations for the evidence and best practices that are informing your plan, as well as for the reference list at the end.

Additionally, be sure to address 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.

Summarize an interview focused on past or current issues at a healthcare organization.
Identify an issue from an interview for which an evidence-based interdisciplinary approach would be appropriate.
Describe potential change theories and leadership strategies that could inform an interdisciplinary solution to an organizational issue.
Describe collaboration approaches from the literature that could facilitate establishing or improving an interdisciplinary team to address an organizational issue.
Communicate with writing that is clear, logically organized, and professional, with correct grammar and spelling, and using current APA style.
Additional Requirements
Length of submission: Use the provided template. Most submissions will be 2 to 4 pages in length. Be sure to include a reference page at the end of the plan.
A number of references: Cite a minimum of 3 sources of scholarly or professional evidence that support your central ideas. Resources should be no more than 5 years old.
APA formatting: Make sure that in-text citations and reference lists follow the current APA style.
Portfolio Prompt: Remember to save the final assessment to your ePortfolio so that you may refer to it as you complete the final Capstone course.