Question

Case Study

You are in a leadership role at a local long-term care home(formerly referred to nursing homes). You have been tasked with evaluating and improving the quality of care in your long-term care home. According to quality reports and the most recent Resident/Family Satisfaction Survey results, your organization is performing below the provincial average. After presenting your findings to the long-term care home board members and leadership team, a decision has been made to focus on changing practices to meet provincial benchmark standards and overall satisfaction with resident care. One of the ideas being discussed is to integrate nurse practitioners to work alongside doctors and nurses.

Results

Two major themes were identified: NPs were seen as providing resident and family-centred care and as providing enhanced quality of care. NPs established caring relationships with residents and families, providing both informational and emotional support, as well as facilitating their participation in decision making. Residents and families perceived the NP as improving availability and timeliness of care and helping to prevent unnecessary hospitalization.

Conclusions

The perceptions of residents and family members of the NP role in LTC are consistent with the concepts of person-centred and relationship-centred care. The relationships NPs develop with residents and families are a central means through which enhanced quality of care occurs. Given the limited use of NPs in LTC settings, there is an opportunity for health care policy and decision makers to address service inadequacies through strategic deployment of NPs in LTC settings. NPs can use their expert knowledge and skill to assist residents and families to make informed choices regarding their health care and maintain a positive care experience.

The board has suggested your recommendation for change therefore the next part of your job as the leader of the home and designated project lead is to develop a change management plan.

Using evidence from the textbook, the lecture material and your personal experience, how would you approach this task?

Are there any other solutions that you might recommend to the board?

Be clear and specific in your change management plan and where appropriate, provide reliable and valid evidence to support your proposed actions.

Please provide complete and correct answer. Maximum one page. Required immediately.    

Thank you.

Answer 1

#IMPROVE THE HOSPITAL PERFORMANCE IN TERMS OF

*ACCOUNTABILITY

*EFFICIENCY

*QUALITY

*EQUITY

*SUSTAINABLITY

*RESILIENCE

THESE PERFORMANCE OUTCOMES CAN BE USED AS MEASURES TO TEST THE EFFECTIVENESS OF POLICY CHOICES AND INTERVENTIONS.GIRFF(GOAL,INSTITUTIONAL ARRANGEMENTS,REGULATIONS,FINANCING AND FEEDBACK)OFFERS A TYPOLOGY OF POLICY DIMENSIONS THAT GOVERNMENTS CAN APPLY,DEPENDING ON THE COUNTRY CONTEXT.

	ACTION AREA	ACTION DOMAINS
IMPROVING HOSPITAL PLANING AND MANAGMENT AND FACILITY LEVEL
1	ACCOUNTIBILITY	Institutional governance struture and processes
Regulatory compliance
Performance monitary
2	EFFICIENCY	Patient managemant
Supply and logistic management
Human resource management
3	QUALITY	Clinical governance structure and processors
Patient safety
Technical quality
Patient and family experience
Continuity of care
4	EQUITY	Service coverage and access
People centered service models
5	SUSTAINABILITY AND RESILIENCE	Infrastructure management
Institutional learning and renewal
Managing shocks
IMPROVING HOSPITAL PLANNING AND MANAGEMENT AT SYSTEM LEVEL
1	GOAL-Hospital as a path to UHC	Links with PHC
Links with non-state providers
2	INSTITUTIONAL ARRANGEMENTS	System level governance
Service planning
Service delivery architecture
3	REGULATION	Facility and provider licensing
Accreditation and external quality assurance
Patient rights
Reporting requirements
4	FINANCING	Delineation and coherence of funding streams
Benefit desighn and service packages
Payment methods
5	FEEDBACK	Quality and patient safety monitory
Access and equity monitory
Efficiency and productivity monitory
risk monitoring for resilience and response

*Embrace a personal ethic of social responsibility and service

*Exhibit ethical behaviour in all professional activities.

*Provide evidenced base,clinically combittend care.

*Incoorperate the multiple determinance of health in clinical care.

*Apply knowledge of the new sciences.

*Demonstrate critical thinking,reflection and problem solving skills

*Understand the roll of primary care.

*Rigorously practice preventive helathcare.

*Integrate population based care and services into practices.

*Improve access to health care for those with unmet health needs.

*Practice relationship centered care with individuals and families.

*Provide culturly sensitive care to a diverse society.

*Partner with communities in healthcare decisions.

*Use communications and information technologies effectively and appropriately.

*Work in inter-deciplinary teams.

*Ensure care that balances individual,professional,system and societal-needs.

*Practice leaderships.

*Take responsibility for quality for care and health outcomes at all levels.

*Contribute to continues improvement of the healthcare systems.

*Advocate for public policy that promotes and protects the health of the public.

*Continue to learn and help others learn.

*Model healthy lifestyle behaviours and attitudes.

*Facilitate client involvement in the assesment,implimentation,evaluation of the health goals.

*Teach clients self care strategies to enhance fitness,improve nutrition,manage stress,and enhance relationships.

*Assist individuals families and communities to increase the levels of health.

*Educates clients to be effective healthcare consumers.

*Assist clients,families,and communities to develop and choose health promoting options.

*Guide clients development in effective problem solving and decision making.

*Reinforce clients personal ans families health promoting behaviours.

*Advocate in the community for changes that promote a healthy environment.