Leading and Managing a Change in Clinical Practice: Patient on Ventilator and the Usage of Saline in Performing Suctioning
Organizational direction depends on many factors. Most of them were an integral part of clinical practice for a while, but until the latter part of the 20th century has been so prominent in the organizational structure. This paper will explore the four factors that influence the management of clinic and are characterized by efficient designs. This paper will discuss about the leadership and management in relation to improving quality, change, care management, values and results. We will also present integration and possible implementation concepts, tools and strategies.
Discussion
Suctioning the patient on ventilator pose a unique challenge in following a clinical pathway or case management model of care. Our patient is on ventilator and we are performing suctioning by the usage of saline solution. Multiple decisions need to be made when our patient on ventilator reaches the point in his or her disease process where suctioning needs to be implemented.
Evidence-Based Practice
This is quite different than the healthcare environment that one is accustomed to managing. Although the environments are different, (Dougherty 2004, 150-896)there are applications that work for either situation. Leadership styles can be used in any area that people are managed by another person. The ability to work through the simulation provided an opportunity to use the three leadership styles and visualize the results from the team. The knowledge gained from the exercise will assist in managing the clinical and non-clinical staff. There will be opportunities that require utilization of the democratic leadership such as staff scheduling, uniform selection, and equipment selection. (Dougherty 2004, 150-896)While other projects will require that the autocratic leadership style is employed, such as policy development, corrective action, and regulatory compliance. The simulation assisted in understanding that leadership has to be flexible enough to know which style is the most excellent for current condition (Dougherty 2004, 150-896).
Planning
First of all effective planning which must be incorporated in all the steps of performing suctioning and should involve proper monitoring system (Levy 2005, 323- 368)?Due to the lack of any lookout event on planning our performance on ventilator would be affected. After you have identified the planning steps you need to decide regularity and frequency (Dougherty 2004, 150-896).
Division of Labour
Then comes division of labour is one of the basic concept of leadership and management for case management as given by Deming; workers hold jobs and managers improved with the improvement of system (Levy 2005, 323- 368). Deming developed the concept of overall management and change management model called the Shewhart cycle, or PDCA (Hamric 2005, 311-335). This model requires that for P-D-plan, do, C-check and A-law (Kelly, 2007, 17-89). Efforts to increase productivity clinical practice is, as pointed out by Deming, necessity and not an option.Deming emphasized that cooperation multidisciplinary teams improves communication channels. Solutions for potential and existing problems, thus more soluble and prevented. These advantages are provided for all areas of the Organization, including helping to contain costs (Dougherty 2004, 150-896).
Role Clarity
Role clarity is also a necessary component of a successful organization. This should be outlined by a clear job description and understanding of how the organizational structure functions (Levy 2005, 323- 368). When these tools are in place the organization will be more likely to successfully adapt to the internal and external factors brought on by the continually changing clinical practice environment (Yoder-Wise, 2003, 174-211). A particularly effective system of analyzing and redesigning clinical pathways was included in a study of suctioning our patient on ventilator, by Owen, et al., (2006). A multidisciplinary team was selected and assigned with the task of evaluating and redesigning the effectiveness of the clinical pathways process. They were known as the process improvement team (Dougherty 2004, 150-896).
Change Management
Encouraging people to willingly accept change and adapt new methods and procedures is a difficult undertaking. All change processes rely on a change agent. The change agent is given the authority to initiate, formally and informally, those processes that will assist in change (Levy 2005, 323- 368) Change agents can be members of the team working towards change by informal or formally appointed positions. Change is a continuous, dynamic process instead of a single occurrence. It is the process by which something becomes different than it was (Sullivan & Decker, 2005). Due to the rapid changes in clinical practice case management has had to recognize change and transform it to meet the demands of clinical practice and consumers. (Hamric 2005, 311-335).
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