Video Scripts

GoReact Video Phase 1

Hello, everyone. My name is Deiokie Rambally. Welcome to my Phase 1 CPE Video Reflection for the D157 course. My Health Improvement Project (HIP) centers on fall reduction in the acute care unit, where patient safety concerns are a problem. This reflective exercise reports my experience in designing and testing the RACI chart in my project and how it will be used to control team communication, collaboration, and accountability: Video Scripts.

The RACI chart was crucially important in the project’s planning, and defining the role was simpler. In this project, I was the project manager. My role was to enhance the development and realization of the fall prevention plan and ensure that the deliverables aligned with the organization’s goals. The stakeholders included the two Inpatient Directors (E.M. and M. O.), the Nurse Manager/Acute Care (J.L.), and the Nurse Educator (A.C.).

When developing the RACI chart, I subdivided the activities into specific tasks: formulating the fall risk assessment checklist, integrating fall risk alerts into the electronic health record, staff training, and long-term observation of fall incidences. In every activity, the RACI chart allowed me to determine who should be Responsible (R), who should be Accountable (A), who to consult (C), and who should be informed (I). For example, in the fall risk assessment tool development, I acted as a project manager, and the Nurse Educator (A.C.) performed the first stage of work to draft and outline the tool. The Acute Care Nurse Manager (J.L.) aligned the tool with clinical workflow and standards.

One key benefit I gained from developing the RACI chart was clarity. There were no questions regarding who would perform what and who had the authority to make decisions. This clarity significantly reduced delays and misunderstandings.

One of the things I realized was the number of people who needed to be informed for transparency, yet were not directly responsible for executing a task. The RACI matrix ensured even peripheral team members were kept up to speed, which was especially helpful in implementation.

The other unexpected advantage of applying the RACI model was how it promoted open communication and respect between professionals despite departmental barriers. It empowered everyone and made them feel like owners of common interests. It enabled every member of the team to have a sense of ownership. Furthermore, the impatient directors participated in a higher administration tier and were consulted at an early planning stage.

Their strategy input also aided in ensuring an efficient way through which decision-making could be achieved, and it also eliminated delays further down the line in the implementation stage. This early involvement emphasized the importance of inclusive partnership during leadership collaborations because this aspect can alleviate resistance and align a project quickly.

Developing the RACI chart also made me return to and review and update other tools I had created earlier, including my SMART goal and Gantt chart. Reviewing these tools allowed me to match the timeline of deliverables with the responsible individuals in the RACI. One deliverable in the planning phase, for example, was to design education materials and training sessions for bedside shift reporting as a strategy for fall reduction.

The staff educator prepared the content; its quality and presentation were my responsibility, and the nurse manager was consulted to provide hospital standards. The staff nurses were informed of the schedule and purpose of the training.

Flexibility was also something I learned in the experience. My first impression of the RACI chart was that it is a strict document, but I soon realized it is evolving. Availability of team members changed as the project went on, with some changes in responsibilities.

For example, when the staff educator went on short-notice leave, I needed to discuss the redistribution of funds with the charge nurse and the nurse manager to ensure education was not affected by this redistribution. Such flexibility reflected how regularly reviewing and tuning project tools was essential.

This activity solidified our timeline planning and raised buy-in from the team members. Individuals were more animated and engaged when they knew where they fit into the larger picture. For instance, physical therapists were only tangentially involved initially.

Still, after their contribution to patient mobility assessments was stated on the RACI chart, they were significantly more engaged in fall prevention. This interdepartmental collaboration enriched the quality of our intervention and revealed how patient safety is an interdisciplinary process.

Moreover, this project as a developing nurse leader gave me an empirical view of leadership as more than making decisions; on a higher level, it empowers others. I discovered that through communication of roles and responsibilities, I could empower my colleagues to behave confidently regarding the areas that had been demarcated. The nurses were also eager to report safety concerns or propose workflow changes because they felt supported instead of micromanaged. This cultural reorientation on the issue of psychological safety, consequently, increased team engagement and morale.

Besides, the RACI chart aided in staff meetings and cooperation. The visual reminder that reflected everyone’s responsibilities kept us focused. It also helped me resolve issues easily when we experienced delays. If the training session were not held on schedule, it would be easy to identify the person who was responsible and held accountable, and collaborate with them to ensure it is back on track.

This also enhanced problem-solving and lowered the risk of blame-shifting, since it could occur when job responsibility is poorly defined. The use of the RACI chart also developed a discussion and response structure. We had a debriefing at project milestones to find out what was working and what was not.

Due to clear roles, we can evaluate individual efforts positively. This helped us to make our performance reviews more constructive and enabled the team to build and develop on a frank assessment instead of a reactive analysis.

Both learning and applying the RACI chart were reflective and instructive. The chart taught me the value of ordered delegation and responsibility in guiding a healthcare improvement project. The RACI tool empowered me as a nurse leader, assuring me in guiding a complex project while maintaining team synergy. It also made me value the level of communication and collaboration necessary to effect even minor changes in clinical practice.

The RACI chart assisted me in improving my time management and organization skills. Creating a plan on who would lead on which part of the initiative helped me to assign realistic deadlines and made a balance between the delegation and the follow-up on the tasks. It allowed me to be more purposeful in meetings, agendas, and progress records. These are among the habits that have not only worked well in this project but will also be valuable in future leadership assignments.

Regarding the long-term effect, the application of the RACI chart preconditioned scalability and sustainability. The chart can be used as an example when we intend to extend fall prevention measures to other units, and can be replicated or adjusted according to the staffing arrangements. This consistency will ensure that the improvement efforts cannot be viewed in isolation but will become a part of an organizational culture of accountability and safety.

In summary, the RACI chart helped define responsibilities, foster teamwork, and enable the success of my fall prevention project. It also facilitated leadership skills and patient safety outcomes. I have also become confident in leading with a structure, intentionally communicating with my team, and supporting my team with clear expectations.

These lessons will be a great guide to further develop into a DNP-prepared leader in healthcare improvement. Thank you for your time.

Phase 2 Video Reflection

Hello. My name is Deiokie Rambally, and in this reflection, I will take you through the process of how I developed my personnel costs table and pro forma operating budget for Phase 2 of my Health Improvement Project (HIP) on fall prevention in acute care. Developing this budget involved coordination, planning, and consultation with stakeholders so that the initiative was not just practical but also cost-effective.

As a background, my HIP focuses on decreasing patient falls in the acute care unit through the institution of a standardized bedside reporting protocol during nursing shift changes. Among the most significant challenges were balancing financial considerations with clinical objectives, defining required human resources, identifying direct and indirect expenses, and estimating the budget across the implementation and sustainability phases. I discovered that the purpose was clinical, such as enhancing safety, but the results needed a meticulous setting of finances and realistic planning.

With budgeting, I recognized that staffing costs would include most of the expenses. Fall prevention is a staff-intensive, hands-on initiative, and labor cost was highly considered. To assist me in being more precise, I collaborated with the nurse manager and unit educator, according to present wages and estimated time involved.

I included staff in training, monitoring, auditing, and coordination. Major roles, including the project leader, nurse educator, inpatient director, nurse manager,/acute care, and two inpatient directors, were key. All team members have a crucial role to play in enabling implementation.

All stakeholders’ contributions in terms of time and scope were relevant to be identified. For example, the nurse educator prepared the materials and delivered the training sessions. In contrast, the Director of Nursing acted as a facilitator, ensuring that the program was aligned with the operations of the hospital and safety objectives.

The Unit Nurse Manager also helped in ensuring compliance and reinforced protocols in daily operations. Such a multi-level engagement required accurate estimates regarding hours and compensation. It was not simply filling numbers in a table, but a prediction of actual work and management time.

Based on the average hourly rate information from HR and verified with my preceptor, I computed the hours needed from each stakeholder in the planning, implementation, and evaluation process. For example, the Nurse Educator had 15 hours to prepare training materials and 10 hours for staff training. The Nurse Manager was assigned 20 hours to coordinate, supervise, and monitor the implementation of the bedside shift reports. These numbers were created to represent actual needs based on the capacity of the unit’s operations.

For simplicity, I laid out the personnel cost table with easy breakdowns by team member, hourly wages, estimated hours, and costs. This made it easier to identify where human resources were most focused and facilitated the pro forma budget. The total personnel costs amounted to around $3,274.30, which was realistic in light of the unit size and level of training.

One thing that came out clearly in this process was how much the personnel time is linked to patient outcomes. The more powerful we employ staff hours, the more effectively we can train, implement, and maintain enhancements. The slight differences in estimating time would significantly change the budget when reproduced through such a massive number of team members.

I needed to eliminate redundancy, compensate for duplication of roles, and not exceed the budget without affecting the integrity of the intervention. This was a learning experience on workforce planning.

I added small but necessary items for non-personnel items like printed training manuals, laminated fall risk assessment flowsheets, room signage, and small rewards like nurse badge stickers. I even added some contingency items, like possible overtime pay in case shifts overlapped for training. The total non-personnel cost was $650, so the overall project budget was approximately $3924.20.

Building the pro forma budget was not an accounting exercise but an exercise in strategy as a nursing leader. Every dollar had to be accounted for in terms of patient safety. Spending on staff education, for instance, was not just an expenditure but a strategy to avoid adverse occurrences like falls and resulting injuries.

Avoiding one or two falls would cost the hospital tens of thousands of dollars in treatment, litigation, and increased hospital stay.

To reinforce my arguments further, I gathered data on the average price of a fall with trauma among hospitalized patients, which can range from $14,000 to $30,000 per fall. In comparison, we had a low HIP budget. This cost-benefit frame assisted in strengthening stakeholder appeals during presentations.

My argument was that there would be considerable cost savings and higher patient satisfaction scores, which are also used to determine reimbursement, and that proactive investment in education and redesigning the workflow would raise the benefits.

One of my sustainability strategies was implementing monthly budget monitoring with stakeholder meetings to review expenditures, track time spent, and gauge resource efficiency. Corrections are made on time, and resources are reallocated where necessary. These check-ups will also be conducted every month to assess the trends in fall incidence and the effectiveness of the training.

If we maintain high fall rates within specific shifts or units, we can detect this early and provide refresher sessions or change responsibility. I have also suggested a new standing dashboard on the shared EHR showing the leadership the latest updated measures and cost reporting. This kind of data transparency is in favor of accountability and continuous improvement.

One key takeaway was the significance of engaging the team in budgeting. Involving stakeholders up front provided a more realistic picture of actual workflow needs and avoided over- or under-budgeting. It also generated buy-in from the team, which will help move forward with implementation. The team members knew why they were assigned their given function and how it supported our patient safety objective.

Another important lesson learned is the necessity of expecting resistance. Some members were initially skeptical of the time requirement to undergo training. In this respect, I presented information on the consequences of fall injuries and provided the RACI chart to identify the roles and expectations.

After the reason was developed, compliance improved. This established the virtue of clear communication in associating the budget tasks with safety objectives.

One logistical issue was arranging training without interrupting care. I overcame this by running training over three days, with catch-up sessions for night staff. This ensured that 95% of nursing staff were trained before implementation without affecting day-to-day operations.

Besides, I included asynchronous alternatives, such as pre-recorded videos and evidence-based tip sheets, to address staff members who cannot come in person. The combination of these methodologies not only increased its accessibility but also showed flexibility and sensitivity regarding the staff’s workload. It also gave continuity to its training type even in future onboarding of its projects, hence its sustainability in projects.

This budgeting activity increased my appreciation for the nurse leader’s role in project management. It demonstrated how prudent resource allocation can enhance or undermine quality improvement initiatives. Budgeting is not a matter of withholding resources but applying them judiciously to support valuable change. This exercise developed my leadership skills, particularly in financial accountability and interprofessional collaboration.

In conclusion, I am satisfied with how the personnel and budget cost table complement the objectives of my fall prevention project. Not only do they portray a realistic budget in terms of finances, but they also demonstrate a firm commitment toward improved patient care. I now realize that budgeting is a leadership conduct, besides being an instrument of patient advocacy. I believe I can steer such initiatives in the future more precisely, more transparently, and with more strategic sense.

Thank you for your time.

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CPE – Phase 1 Video Reflection

Activity Details

StandardAttempts: Unlimited

Recording Instructions

Create a 5-10 minute GoReact video reflection of your clinical practice experiences that discusses your RACI chart.

After submitting your video, watch two of your peers’ videos and provide them encouraging and constructive feedback.

CPE – Phase 2 Video Reflection

Activity Details

StandardAttempts: Unlimited

Recording Instructions

Create a 5-10 minute GoReact video reflection of your clinical practice experiences describing your personnel costs table and pro forma budget.

When you have finished your recording, provide constructive and positive comments on two peers’ videos.

Client’s Notes:

• Health Improvement Project-FALL PREVENTION IN ACUTE CARE
• This course is a continuation of D156- (I have attached the final copies of D156 as a guide – some of the dates I changed to match the dates my requirements was met)
  • Please follow this link for materials
• Use the CPE record as a guide into writing the paper
  • CPE RECORD GIVES THE DIRECTIONS FOR THE EPORTFOLIO
• ALL THE COURSES WILL BE A CONTINUATION OF THE PREVIOUS CAPSTONE PROJECTS DONE

Sample Videos:

• Sample Goreact Video Phase 1
• Sample Goreact Video Phase 2