HADM 528 Organizational Behavior in Health Care Assignment

You are a Consultant of Organizational Behavior.

1. Discuss barriers for effective patient care. What are the key challenges and issues?

2. Provide recommendations that will address the issues outlined in Q1.

Answers:

Background

Effective patient care deals with the techniques and administration that enhance the care and support that are to be delivered to the patients after they are admitted in hospitals or after they undergo any process of surgery. The care that is provided to the patients involves support of the doctors, their supervision, effective prescription, certain organizational theories to be implemented by the hospitals, nurses’ supervision along with the training and educational requirements of the nurses (Cochrane et al. 2007). Moreover, the infrastructure of the hospitals must be up-to-date along with well implemented administrational procedures. The case that is illustrated here depicts the poor management, ill infrastructure and stressful situations in the care giving units that ultimately lead to ineffective patient care process. Therefore, the key issues that hinder the effective patient care will be highlighted in the next section thereby making certain recommendations that might stimulate effective patient care (Roussel, 2006).

Key issues

First of all, the key issues that hindered the effective patient care process in the urban hospital of Israel as cited by Sara were the management’s negligence and callousness towards the setting up of proper infrastructure such as beds and differentiated units for different patients. It is noticed from the source that often the patients were moved and placed in units where they did not belong. For example, the orthopedic patient who underwent surgery due to bike accident was placed in the ophthalmological unit due to shortage of beds. Further, it was not only a case that Sara was reporting but also there were 10 other ophthalmology patients that night who Sara had to provide care to. This kind of situation gives rise to a lot of stress among the patients and the nurses or the care givers (Borkowski & Deckard, 2013).

There are few more articles that are based on similar topic to analyze the barriers to patient care. In one such article which used thematic analysis, comprising 16 female nurses and 5 male care givers from Iran cited out reasons and aspects that influence the patient care process. The average age of the nurses was 33.5 years while the average span of their nursing experience was 10.5 years. The factors influencing poor patient care as cited by them (Rao, 2002)

Poor coordination among themselves and ineffective teamwork

The nurses stated that there was absence of team coordination which led to an isolated feeling while providing care to any patient. There were care givers who selfishly looked for their personal set of interests above their duties of care giving (Wilson, 2008).

Personal hindrances

Personal problems faced by the care givers in their job profile affected their quality of work. Often due to low human resources, the nurses have to work for long hours that contributed stressful situations to both the nurses and the patients. Moreover, the care givers felt de-motivated quite at times due to low payment structure and other notable problems relating to the infrastructure in their workplace (Farahani et al. 2011).

Organizational and infrastructural hindrances

This kind of hindrance can be considered as far more challenging than the other two. Though the healthcare organizations tout the very idea of patient centric care as their primary aim, still they are falling short to fill the gaps with effective and trained human resources, infrastructure, use of updated technologies, proper staffing solutions and others (Luckett et al. 2013).   

Organizational Theories and their applications

There are certain health care standards set. Nonetheless, these standards are nothing but aims and objectives that the health care organizations strive to cater to promote better patient care facilities. They are as follows:

• Health care processes catered must render a form of safety and security to patients
• The health care organizations must be effective in their actions thereby implementing well upgraded health care facilities
• Health care centers must be “patient centric”
• Health Care organizations must act within time and must cater prompt service to its patients
• Equality must be practiced in the health care organizations (Wilson, 2008)

These objectives seem appealing and noteworthy. However, there lies a gap between these theories and those that are practiced. There are certain practice models set for the nurses such as the Magnet Recognition Programs, Differentiated Nursing Practice, Interdisciplinary collaboration and many others. Though the nurses pursue these training programs, ultimately it depends upon the health care organizations and their methods of in house working processes. Certainly, it is the healthcare organization that can rate and evaluate the qualities of its nurses and bring them to use (Grol et al. 2007).

Magnet recognition programs are for the chief nurses and the nurse administrators; Differentiated Nursing practice provides a training that is differentiated through parameters like educational level, clinical skills, through pay structure as well as through the participation in decision making process. Interdisciplinary collaboration refers to the collaborative decision making that take place among the health care givers. It is often characterized by trust, respect, and effective communication that the care givers share among themselves (Luxford et al. 2011).

According to the organizational theories, it is illustrated that the “professional nursing practice” should be assisted through a professional surrounding and ambience. The health organizations should acknowledge the professional contributions made by the care givers and must bring into use their natural areas of expertise and skills. They must also allow the nurses to participate in the decision making procedures relating to the “unit based programs” (Farahani et al. 2011).

There should be training interventions for the nurses in order to keep them upgraded. Feedback from the colleagues, nurse administrators, patients and other co-workers must be collected so that the health care organizations can reward the deserving workers. Collaborative relationship must be cultivated by the health care centers among the physicians, nurses and other health care personnel so that a positive and care-giving environment is instilled through the formation of bioethics committees and other governing frameworks (Luckett et al. 2013).   

Recommendations

There are certain parameters that the health care organizations must abide by which is inclusive of both non-medical and medical factors. Non-medical factors such as accessibility as well as availability of the doctors and the nurses must be there for all sorts of patients. Time is an important factor that must be utilized aptly. For example, Sara’s orthopedic patient and Sara had to wait for 3.5 hours to get the proper medication for pain. This waiting time must be minimized. Patient information should be effectively communicated among all the personnel who deal with the patient. Management is another significant aspect witnessed in Sara’s case “Whose patient is it”. The management should be cooperative and must discuss the problem scenario with the workers thereby making them a part in the decision making processes (Breen et al. 2009).

While viewing from the medical aspect, it is recommended to hire trained professionals who are aware of their duties. Again citing from “Whose Patient is it”, it is noted that the orthopedic surgeon diverted his calls to voice calls which exhibit his irresponsibility. There should be well equipped infrastructures and instruments as well as implementation of advanced technologies (Grol et al. 2007).

Outcomes

On the basis of the recommendations, the outcomes to effective patient care can be rated through several processes like holding interviews with the patients, nurses, physicians and the other care givers. Researches can be conducted pertaining to the quality and effective patient care process thereby forming questionnaire relevant to the topic and generating answers from the same. Moreover, the usage of updated technique and technologies can be analyzed for the purpose of outcome (Roussel, 2006).    

References

Borkowski, N., & Deckard, G. (2013). Case Studies in Organizational Behavior and Theory for Health Care. Jones & Bartlett Publishers.

Breen, G. M., Wan, T. T., Zhang, N. J., Marathe, S. S., Seblega, B. K., & Paek, S. C. (2009). Improving doctor–patient communication: Examining innovative modalities vis-à-vis effective patient-centric care management technology. Journal of medical systems, 33(2), 155.

Cochrane, L. J., Olson, C. A., Murray, S., Dupuis, M., Tooman, T., & Hayes, S. (2007). Gaps between knowing and doing: understanding and assessing the barriers to optimal health care. Journal of continuing education in the health professions, 27(2), 94-102.

Farahani, M. A., Sahragard, R., Carroll, J. K., & Mohammadi, E. (2011). Communication barriers to patient education in cardiac inpatient care: A qualitative study of multiple perspectives. International journal of nursing practice, 17(3), 322-328.

Grol, R. P., Bosch, M. C., Hulscher, M. E., Eccles, M. P., & Wensing, M. (2007). Planning and studying improvement in patient care: the use of theoretical perspectives. Milbank Quarterly, 85(1), 93-138.

Luckett, T., Davidson, P. M., Green, A., Boyle, F., Stubbs, J., & Lovell, M. (2013). Assessment and management of adult cancer pain: a systematic review and synthesis of recent qualitative studies aimed at developing insights for managing barriers and optimizing facilitators within a comprehensive framework of patient care. Journal of pain and symptom management, 46(2), 229-253.

Luxford, K., Safran, D. G., & Delbanco, T. (2011). Promoting patient-centered care: a qualitative study of facilitators and barriers in healthcare organizations with a reputation for improving the patient experience.International Journal for Quality in Health Care, mzr024.

Rao, G. N. (2002). How can we improve patient care. J Community Eye Health, 15, 1-3.

Roussel, L. (2006). Concepts and Theories Guiding Professional Practice.

Wilson, E. V. (Ed.). (2008). Patient-centered e-health. IGI Global.