Macro Level Coordination In Nursing

ABSTRACT: Delegation refers to the practice of a registered nurse assigning certain tasks and activities to other people while still maintaining responsibility for the actions of the others to whom responsibility has been delegated. The act of delegating assumes that the delegator has a certain amount of trust in the person to whom they delegate. Additionally, quality communication is paramount in maintaining superior patient care when delegating tasks to others. One signifigant obstacle to delegation is ensuring that the proper tasks are delegated to the appropriate individuals. The organizational structure and leadership

To effectively manage the discharge of individuals and transfer of care between settings, the social service team at UPMC-MDU start early to anticipate problems and discuss barriers and reoccurring traumatic events, but most importantly, patients and multidisciplinary team, via daily meeting, are involved at all stages of the discharge planning and medical treatment process. Considering this process and significance to employ a person-in-environment approach, I have become more aware of the need for skillful care coordination to achieve the most successful clinical and

Interprofessional team collaboration for professional nurses is viewed as a method to improve the care and safety for patients. However, interprofessional team collaboration presents both advantages and challenges for nurses and other team members. One of the advantages is the coordination of care for the patient and the sharing of knowledge to improve the outcomes for the patient. Challenges for interprofessional team collaboration is: poor role-definition, miscommunication, conflict, lack of accountability for assignment of responsibilities and tasks (Reeves, 2012). This paper will discussion the role of a nurse on an interprofessional team and the challenges, why interprofessional teams promote patient safety, and strategies to promote success interprofessional teams.

Hospitals have organizational structures that allows them to carry out their duties efficiently and successfully. What separates the organizational structure of a healthcare organization from a business, essentially that the hospital 's organization is chiefly founded on the amalgamation of medical and administrative staff (Carayon, et al., 2014). The organizational structure of the twenty-first century solutions in health care hospitals involves, both divisional and hierarchical structure. In the of the chain of command hierarchy, there are various levels of professional’s that fall under other levels within the facility, and each staff member is organized in regards to departments that are related to their (KSA’s) skills, attributes and job duties (Carayon, et al., 2014). Hospital organization philosophies is based on development of values and ethics, with the understanding on moral principles relating to human conduct. These systems are comprised with the processes in decision making and determining the best actions to consider between the difficult alternatives when pertaining to patient care.

With my experience so far on that unit, one the barrier of interdisciplinary team work is that, it involve so many aspects of hospital bureaucracy and protocols to follow which can cause delays in patient care. For example, sometime l will get a direct admission to the floor and the patient will be complaining of pain but the attending physician has not put orders in the system yet. According to the hospital policy, I needed to call the doctor put the order in and incase the patient have a pressure ulcer, I will call the wound care nurse to come and assess the patient also. I understand that all this policies is to protect patient safety, but so many times l would page the doctor and he would take hours to respond. With this various protocol, it is causing delay to attend to patient needs. Working in collaboration with other healthcare professionals; involve a lot of time consuming, which is affecting patients to get care in time. Miscommunication between interdisciplinary teams is another barrier that is affecting effective health care delivery. A smooth communication between healthcare professionals would increase quality health care and safety. If there are problems in how healthcare professional communicate and interact with each other, the problems and error in patient care can occur (Zwarenstein et al. ,

Interdisciplinary teams in nursing basically focus on results on the basis that the involved participants share the responsibility for achieving these outcomes. These teams comprise of members from different practices in the healthcare field who gather information to achieve consensus. Based on the required skills at a specific time, the leadership of these teams may be rotated among the associates or team members. In order for the interdisciplinary teams to function effectively in the nursing field, their leaders primarily facilitate instead of directing the collective work. Interdisciplinary teams function effectively through establishing clear goals, evaluating progress, plan ahead, clarify roles, share the leadership, and capitalize on individual talents (Wenckus, 2004).

Organizational Structure Organizational structure can be defined as a social unit of people, systemically structured and managed to meet a need or pursue collective goals on a continuing basis. My organizational structure consists of management that determines the positions and delegate roles, responsibility to carry out defined task. On a daily basis, there is a charge nurse that supervises the entire unit and makes adequate assignments for each member of the nursing staff. The charge nurse can also be used as a resource in any event that is questionable to the nurse, patient and the family members. Our organizational structures promote teamwork, improve communication and provide quality care.

“Running a health care organization is a team sport. It is very important that all members of the team-whether on the medical staff, in management or on the board-understand the role of governance and what constitutes effective governance” (Arnwine, 2002). Running a hospital is a difficult task. Several factors need to be seriously thought of and considered in every decision and undertaking. Unfortunately, all the three important factors in governing a hospital is not always in harmony. As likened to a team sport, if the three major components are not working with each other as a team, there will be tension and a great divide will be experienced. And often times, the patients will be in the middle and will be greatly impacted. This writer believes that there are several factors that contribute to the tension that usually exists among the medical staff, the board and administration. One factor is the disconnect, where each entity is not seeing each other eye to eye and their visions may be different from each other. Another factor may be the lack of communication in order to bridge the gap and to build a respectful and a relationship wherein there is trust for each end every member of the group. Often times, the medical staff is concerned with ensuring that patients are cared for in a manner that their practice is protected as well as the patients are getting the appropriate care. On the other hand, the board of trustees may be focused in ensuring that that

According to the Agency for Healthcare Research and Quality (2015), "care coordination involves deliberately organizing patient care activities and sharing information among all of the participants concerned with a patient's care to achieve safer and more effective care". This multidisciplinary team usually includes nurses, patients, physicians, social workers, physical therapists, pharmacists, etc. Care coordination across the continuum improves communication, quality of care, patient safety and patient satisfaction while reducing admissions and readmissions and medical costs. Another activity, public health nursing involves collaboration and partnerships with communities and special population, with a focus on health promotion and preventative care (Kulbok, Thatcher & Meszaros, 2012). Public health nursing includes home care, clinics, case management, and local and state health departments, etc. Finally, nurses joining committees is another way to strengthen healthcare. For example, a readmission review committee involves nurses from the hospital, case managers, social workers, hospital physicians, skilled nursing facility physicians, etc. who come together to review patient cases and identify why patients were readmitted, what fell through the cracks and then develop workflow/protocols to minimize the chance for future readmissions. Committees like these improve patient care and

Care coordination within health care systems ensures the client of an effective and short stay. Care coordination refers to the coordination between and among professional teams that serve valuable roles involved in providing care to clients. Different disciplines of health care professionals include nursing, medicine, case management, pharmacy, nutrition, social work, and allied health professionals, such as speech therapists and physical therapists. They are found in all health care delivery systems and are extremely effective when the focus is strictly on the needs of the client. Interprofessional teams are valuable because each health care professional has specialized knowledge and skills so that health care plans are determined with

According to American Nurses Association (2010) Scope and Standards of Nursing Practice, collaboration is defined as, “a professional healthcare partnership grounded in a reciprocal and respectful recognition and acceptance of: each partner’s unique expertise, power, and sphere of influence and responsibilities; commonality of goals; the mutual safeguarding of the legitimate interest of each party; and the advantages of such a relationship”.(p. 64). Collaboration amongst health care providers is very crucial in providing quality care to patients. Integration of disciplinary teams, improves communication, coordination, and most importantly, the safety and quality of patient care. It provides interaction between team members allowing

This is a reflective essay based on a event which took place in a hospital setting. The aim of this essay is to explore how members of the Multidisciplinary Team (MDT) worked together and communicate with each other to achieve the best patients outcome.

During the team formation, a number of challenges manifested. Firstly, it was the fact that there were nurses from other units. Hence, there were fears that they may not be well informed with procedures undertaken in our unit. However, this challenged was effectively addressed by assigning the nurses from other units a nurse from our unit to help her during the emergency period.

Teams working in a hospital or other healthcare setting may consist of several physicians, nurses, medical assistants, referral coordinators, pharmacists, therapists, and students among others. Such large teams can provide comprehensive care for complex and chronic illnesses, but when they fail to work well together, they

The organizational structure is as important as culture for health organizational to provide best care to patients. According to Glickman, Baggett, Krubert, Peterson, and Schulman, (2008) "Organizational design is a formal, guided process for integrating the people, information, and technology of an organization, and serves as a key structural element that allows corporations to maximize value by matching their corporate design to overall strategy." It is really hard for large organizations to provide high quality of care when the organization structure is not set properly. Most large health organization have their work divided into small tasks and each employee is responsible for his or her duties. As I have discussed earlier communication is major problem in health organization that leads to many medical errors. Without clear communication between