Research Question The proposed project seeks to adopt the hourly rounding for purposes of reducing the call bells on a medical, surgical pulmonary unit involving patients. The clinical question can be stated in PICOT format for ease of comprehension. Population (P): Patients on a medical, surgical pulmonary unit Intervention (I): Hourly Rounding Comparison (C): Current patient monitoring plan Outcome (O): Improve HCAHPs scores and reduce call bells Time (T): A month of hospitalization From the attributes mentioned above, the clinical question can be stated as “For patients on a medical, surgical pulmonary unit; how the implementation of hourly rounding compares to the current patient monitoring plan help improve HCAHPs scores and reduce call bells within a month of hospitalization?” Lewin’s Change Theory …show more content…
Kurt Lewis developed this theory. It consists of three significant concepts to enforce change. The three concepts are made up of three stages which are unfreeze, change, and freeze stage. The first stage, which is the unfreeze stage is a method of making it possible for people to let go of an old pattern to adapt to a new one. The second stage; change stage is when people are adapting to the change, and this is when new behaviors and attitudes are developed. The change is being implemented at this stage. The final stage, which is the freeze change is when people adapt to this change as a new habit so that it becomes the new norm. If this final change did not take place, it could be easy for the healthcare staff to go back to old
This standardized dialect is also pertinent for medical schooling and teaching in addition to clinical research and studies conducted by scholars, scientists, and physicians by providing a valuable foundation for domestic and coast-to-coast operation evaluations. CPT is used to describe doctor’s services, a vast amount of administrative services in addition to operating services executed in medical facilities, treatment care centers, and outpatient divisions. Providing support for clerical duties and functions such as processing medical claims and initiating strategies and procedures for the evaluation of clinical care is another cause of relevance for CPT. The system also meets the need for tracking trends and identifying improvements, plus progression goals and scaling the value of healthcare services received by patients. The CPT coding system provides physicians throughout the United States with a consistent method for classifying and coding clinical procedures which in return provides a more efficient tool for recording and reporting task that were completed. Physicians, scholars and payors, have been dependent upon CPT to interconnect with other fellow associates, patients,
Quality of service should be one of the most important and well monitored goals for any medical facility, from your small town family doctor’s office, to nursing and rehabilitation facilities, all the way to large hospital systems. The quality of service provided in a facility doesn’t just affect the patients. Quality of service also affects the bottom line, or whether or not the hospital system is profitable. In order to better access the system’s current quality of service and to devise improvement plans I would need to explore issues that have significant effect on quality of care such as, patient satisfaction and retention, medical errors
Devote effort to focus on patient’s need for help with toileting, pain level, and positioning.
The economic cost for the clinic due to waiting times rise. By taking more time to process the patients, the clinic cannot reach its potential of seeing 108 patients. This of course results in less revenue. Currently the clinic operates at 74% capacity, resulting in a loss of 26% revenue.
Hourly rounding is something that has been around for a while. One of the first things we learned in nursing school was that you should check on your patient every hour or every 2 hours (depending on nursing aid assistance). I started my research by looking at what hourly rounding entails. From there I found the majority of articles that think hourly rounding really does affect patient care and only a few opinion articles that think the opposite.
A change that a nurse manager could implement that would help improve patient care is hourly rounding. In order to implement this change successfully, the nurse manager needs to clearly communicate the expectations, and then follow up with good monitoring. When the nurse manager sees the staff meeting the expectations the staff should be acknowledged rewarded/recognized and celebrated. On the other side, if the staff is not meeting the expectations they should be reminded, coached, and counseled. Sticking to the communicated expectations can have powerful results when the nurse manager diligently and consistently puts the plan into practice.
2. Analyze the available MD and NP capacity. How effective is the clinic in matching supply and demand?
When the project is a proven success, the hospital should consider implementing hourly rounds instead of odd-hour rounds. Employee satisfaction contributes to satisfied customers. Hourly rounding promotes high-quality patient care to improve patient outcomes; this is vital in healthcare delivery today (Studer, 2007).
Lippitt’s Phases of Change Theory Lippitt, Watson, and Westley (1958) extend Lewin’s Three-Step Change Theory. Lippitt, Watson, and Westley created a seven-step theory that focuses more on the role and responsibility of the change agent than on the evolution of the change itself. Information is continuously exchanged throughout the process. The seven steps are:
Data collection can be subdivided into three categories with service type, department, and floor. This collection of data is valuable tool that managers need to have in order to understand the flow of business within each department. With the collection of data it will allow managers to calculate the volumes of patients during specific times.
The model represents a very simple and practical model for understanding the change process. For Lewin, the process of change entails creating the perception that a change is needed, then moving toward the new, desired level of behavior and finally, solidifying that new behavior as the norm. The model is still widely used and serves as the basis for many modern change models.
Relating this unit project to Kurt Lewin’s Change Theory involves taking into consideration all three steps of this model. The first step is called Unfreezing, and according to Change Theory on currentnursing.com, it is the “process which involves finding a method of making it possible for people to let go of an old pattern that was counterproductive in some way” (2011). Unfreezing is meant to help address the potential stress related to individual and group resistance and opposition to the intended change. It is achieved by first determining a change that needs to be implemented and gaining support from the management of the unit. The oral immune therapy change idea was approved and supported by the nurse manager of the NICU. Unfreezing also involves motivating a desire for the
The Author did use one graph to identify the most common use for the call light and another graph was used to identify the frequency of call light usage in baseline one- hour rounding and two-hour rounding. Author used t test for comparisons of patient satisfaction scores. The researcher used statistical software to identify the difference between two independent means. Two vendors at the hospital were tracking patient satisfaction score, the sample size and standard deviations. These scores used for t calculations (Meade, Bursell, Ketelsen , 2006).
Prior to the hourly rounding implementation, all the clinical staff (staff involved in patient care) will attend an hour workshop, which will cover the advantages and significance of hourly rounding to patient safety, reduction of falls, increase patient satisfaction, improved health outcomes, and financial impact to the organization. A video on how to do the hourly rounding properly and what behavior to avoid will be shown. After the workshop, the staff will do return demonstration, playing the role of the staff, while being checked off to ensure that the expectations during hourly rounding are met. This includes how to properly introduce oneself to the patients, informing the patients that the staff will be rounding every hour till 2200 then every two hours till 0600, to address their pain, possession, position, and potty needs. By performing return demonstrations, the validators (nurse managers, educators) will be able to ascertain that the staff understood and will
3. How many operations could the hospital perform per day before running out of bed capacity? How well would the new resources be utilized relative to the current operations? Why?