Assessment 3: Policy Proposal Presentation

Hello and welcome to today’s presentation on the policy proposal for reducing waiting time in the emergency department. Over the years, this issue has remained unsolved and has huge implications on patients’ health and the facility at large. This presentation is designed to give you, stakeholders, all the necessary information and supporting evidence about the need to change the current situation. Waiting time at the ER must be reduced by all means at CareM Medical Center. We will discuss the relevant benchmark metrics obligating the need for a policy and stakeholders’ role in implementing the proposal to ensure that CareM Medical Center’s performance matches the federal and state benchmarks.

Proposed Organizational Policy and Practice Guidelines

}Empowering nurses to work through:

}Increasing their numbers to meet the desired ratio

}Adding beds in the ER

}Allowing nurses to admit patients directly after diagnosis

}Guiding principle: nurses are being overwhelmed in the current situation

}Objective: empower nurses to work better by reducing workload and barriers to effective care

CareM Medical Center can apply several strategies to reduce waiting time in the emergency department. Since the current benchmark metrics focus on patients with substance use disorder (SUD), there is a high chance that other assessment areas are being underserved. One way of changing the current situation is empowering nurses to be more capacitated to work. The current nurse: patient ratio in the facility’s ER is 1:5. California recommends a nurse-patient ratio of 1:4 in the ERs (Sharma & Rani, 2020). The addition of hospital beds is also a practical intervention. The medical center should also consider limiting patients’ flow to the ER by empowering nurses to admit patients after diagnosis directly.

Applicable Health Care Policy

}Current average waiting time in CareM Medical Center: 80 minutes

}Federal recommendation: 40 minutes

}Current nurse: patient ratio- 1:5

}California State recommendation- 1:4

}Implications: focus should be increasing nurses to reduce workload

}Reduced workload will reduce waiting time

Many practice areas have been affected in the current scenario, and it is evident that improvements are crucial. The most applicable

health care policy is the regulation on waiting time that requires emergency rooms to have an average of forty minutes. Given that Care Medical Services has been recording as high as eighty minutes, the interventions used should focus on reducing waiting time to below 40 minutes.  The problem of waiting time is worsened because the number of nurses in the facility is still a concern. As a result, practice interventions should try to work on ways to increase the number of nurses to reduce workload.

Relevant Benchmark Metrics

Benchmark Metrics

}Waiting time- double than the required average

}Number of nurses- lower than state’s average in an ER

}Number of beds- low to allow quick clearance of patients

Implications

}Possibility of legal and ethical issues/violations

}Damaged hospital’s reputation

}Reduced competitiveness

The most affected benchmark areas are waiting time, the number of nurses, and the number of beds. The low number of nurses and beds increases the number of patients, increasing waiting time. If the medical center does not make any changes, there is a huge chance of legal and ethical implications. Health care organizations must always operate as legally, ethically, and professionally mandated. The other adverse consequence of not making any change is reduced competitiveness. Zhang et al. (2017) postulated that the nurse-patient relationship is ruined when health care organizations fail to deliver as expected. Patients lose the facility’s trust and are likely to look for medical assistance in other facilities due to diminished trust. To avoid such impacts, it is advisable to act soonest possible.

Impacts of Policy and Practice Guidelines on Stakeholders- Part 1

}Impacts on how you do your work: more involvement in health care management

}Altering certain tasks: become pillars in formulating care plans

}Workload: take time in change processes

}Responsibilities: evaluation of practice programs and promoting change

Health care organizations should always provide health services that match the expected quality standards. One way of ensuring that practices meet the expected standards is by using benchmark metrics. As this happens, stakeholders are centrally involved and affected in various ways. If the proposed policy guidelines succeed, you will be more involved in health care management in CareM Medical Center, unlike in the past. You have to be pillars in formulating care plans to ensure that CareM Medical Center has addressed the waiting time problem. As part of the changing responsibilities, you will be involved in evaluating practice programs and promoting change.

Impacts of Policy and Practice Guidelines on Stakeholders- Part 2

}Improving working conditions: will improve working relationships

}Quality and outcomes: satisfaction, more output, patient-centered activities

}Quality of the stakeholder group: better service providers, influence will increase

}Being more successful: using position to improve public health

A close analysis of CareM Medical Center’s performance suggests that high waiting time in the ERs is a genuine concern due to the center’s dismal performance in this area. Accordingly, stakeholders should support policy changes to enhance performance. Active engagement in implementing policy and practice guidelines will improve the working relationship among stakeholder group members. Changing the current situation for a better position of patients in the facility will lead to satisfaction, more output, and involvement in patient-centered activities. Your influence in the facility will increase while working as key members of improving public health. Doing so will lay a good foundation for the expansion of the facility and the achievement of other goals more conveniently.

Evidence Presenting Alternative Perspectives

}Improve health care facilities’ productivity by:

}Considering expansion

}Minimizing regulation

Case Illustrations

}Increasing physicians admission capacity and not limiting it to the ER

}Quick clearance in the ER

}Restricting emergency care to patients with proven emergency problems

Evidence-based literature is awash with alternative perspectives for improving waiting time in the emergency rooms. Ravaghi et al. (2020) suggested that hospital expansion should be highly considered, and hospitals should not be regulated extremely. A fitting example of an extreme regulation is limiting admission capacity to the ERs. In the same case, emergency care should be restricted to patients with proven emergency problems. Admitted patients should not be boarded in the emergency departments; clearance should be as quick as possible (Chrusciel et al., 2019). Such strategies can prevent overcrowding in ERs and improve hospitals’ capacities of meeting all patient needs.

Strategies for Collaboration

}Establishing and working on clear goals

}Communication

}Interacting through chat rooms and screen to screen meetings

}Regular conference calls

}Lunch meetings for progressive review

Implementation of this proposal cannot succeed without collaboration. All the involved parties must work closely together with others and work towards achieving the new vision. One way of collaboration is by working on specific goals. Since each represented area understands its role in making the plan to succeed, it is crucial to be more focused on the assigned role and keep communicating with the rest of the team. Interactions are necessary and chat rooms can ensure that everyone can clarify anything or look for support when in need. Regular conference calls are another way of collaborating and lunch meetings are vital for progressive reviews.

Role of the Stakeholder Group

}Stakeholder group: CareM Health Council

}Composition: administration, donors, and community representatives

}Administration’s role: provide resources

}Donors’ role: support change processes

}Community’s role: supporting change

The stakeholder group in this proposal is the health council of CareM Medical center consisting representatives from administration, donors, and the community. On its part, the hospital administration has access to resources, and it is well-positioned to search for more financial resources for practice improvement. If they can be convinced about the implications of high waiting time on patient outcomes, administrators can collaborate with donors to make the desired change. The reputation of a health care facility depends on how well it serves the community. For the community to support the necessary changes and to continue seeking health care services from the medical center, active engagement is crucial.

Importance of the Stakeholder Group and Collaboration

}Stakeholders are organizational pillars

}Stakeholders influence policy changes

}Keeping CareM Medical Center free from ethical and legal issues

}Avoid questions that would cause resistance to change

}Stakeholders are think tanks for policy formulation and implementation

We will close this presentation by looking at your importance and the need for collaboration. Firstly, stakeholders are organizational pillars. They influence policy changes, and an organization is likely to succeed when stakeholders are at the center of changes. Secondly, stakeholders’ participation will ensure that CareM Medical Center is free from legal and ethical misconduct. Engaging stakeholders from the start ensures that no questions will be asked later regarding the use of resources and changes in operational procedures. Above all, stakeholders serve as think tanks for policy formulation and implementation. They propose creative ways of making policy changes, instrumental in making a policy more robust and implementation easier.

References

}Chrusciel, J., Fontaine, X., Devillard, A., Cordonnier, A., Kanagaratnam, L., Laplanche, D., & Sanchez, S. (2019). Impact of the implementation of a fast-track on emergency department length of stay and quality of care indicators in the Champagne-Ardenne region: a before–after study. BMJ open, 9(6), e026200. http://dx.doi.org/10.1136/bmjopen-2018-026200

}Ravaghi, H., Alidoost, S., Mannion, R., & Bélorgeot, V. D. (2020). Models and methods for determining the optimal number of beds in hospitals and regions: a systematic scoping review. BMC health services research, 20(1), 1-13. https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-020-5023-z

}Sharma, S. K., & Rani, R. (2020). Nurse-to-patient ratio and nurse staffing norms for hospitals in India: A critical analysis of national benchmarks. Journal of Family Medicine and Primary Care, 9(6), 2631. doi: 10.4103/jfmpc.jfmpc_248_20

}Zhang, P., Wang, F., Cheng, Y., Zhang, L. Y., Ye, B. Z., Jiang, H. W., … & Liang, Y. (2017). Impact of organizational and individual factors on patient-provider relationships: A national survey of doctors, nurses and patients in China. Plos one, 12(7), e0181396. https://doi.org/10.1371/journal.pone.0181396