Sharp HealthCare, a well-being maintenance provider located in San Diego, is a medical organization that includes several hospitals, medical groups, and centers. Sharp HealthCare traces its roots from the establishment of Donald N. Sharp Memorial Community Hospital, named after the young pilot from San Diego who sacrificed his life near Bonn, Germany in the time of the Second World War. His father, a businessman, to commemorate the brave deed of his son, donated a particular sum of money to San Diego Hospital Association with a wish that the newly established hospital be identified as a medical institution for serving those, “who sacrificed their lives” (Sharp, n.d., para. 2).
Sharp HealthCare describes itself as a non-profit medical organization. According to the institution, it means that Sharp HealthCare contributes the money left after covering the costs such as utility bills and salaries to the improvement of human and technological resources of the organization. The medical institution differentiates itself from for-profit health providers as far as donators and investors are concerned. For example, Sharp HealthCare’s members of the board are the community representatives whose primary interest is the well-being of their constituents.
The structure of Sharp HealthCare incorporates five hospitals (Coronado, Grossmont, Memorial, Mesa Vista Hospital, and Mary Birth Hospital for Women and Newborns), two medical centers (Chula Vista and McDonald Medical Centers), and three medical groups (Rees-Stealy, Community, and SharpCare Medical Groups).
Sharp HealthCare has several information systems. The Laboratory Information System is represented by the services provided in various locations throughout the county via Rees-Stealy Medical Group and the laboratory services at Sharp hospitals. The system integrates all laboratories of Sharp HealthCare and provides the availability of information in different facility centers. Via Rees-Stealy Medical Group, a patient can find a provider of the laboratory services the closest to her location. This service enables test results to be available to doctors and patients.
Moreover, Sharp HealthCare has an integrated patient self-service system that helps manage such activities as paying medical bills, monitoring health records, making appointments, searching for doctors, and involvement in the healthcare classes. Therefore, patients can learn how to improve their well-being, get access to health information about their condition and treatment procedures, and manage appointments and requests for special services.
Partnership programs with other institutions allow integrating of Sharp HealthCare’s information systems into the networks of partner organizations. The illustration of such a process is a cooperation between the San Diego Alzheimer’s Disease Research Center (ADRC) and Sharp HealthCare in the implementation of the Care Transition Intervention through the reception of a Tech4Impact grant issued by the Center for Technology and Aging. Patients who require information or medical support considering their chronic conditions can “use the San Diego ADRC Network of Care (NoC) website to locate services and resources, plan for their long-term care needs, and learn how to improve their health and wellbeing” (The Office of the National Coordinator for Health Information Technology, 2013, p. 15).
The necessity of information systems for Sharp HealthCare is essential considering the structure of the organization. Since the medical services provider has a vast network of hospitals, medical centers, and groups, the information system, which includes various sub-divisions, assists in the coordination of information flow, improvement of medical services, and enhancement of patients’ awareness about their well-being. Moreover, the integration of the patient self-service into the information system of the medical organization advances the communication between doctors and patients.
Sharp. (n.d.). Our Story.
The Office of the National Coordinator for Health Information Technology. (2013). Health IT in Long-Term and Post Acute Care.
Kendall Regional Medical Center: Pressure Ulcer Problem
Health care management can be seen as the optimization of internal and external processes within the institution. The effective manager affects the levels of income and expenses, administers the work of the personnel, and ensures the implementation of organizational objectives (DeWit & Kumagai, 2014). Moreover, successful managers know the ways to influence employee teams through the application of diverse leadership styles. It should be noted that any management process takes place in particular political, social, and economic conditions; the changes in these conditions entail alterations in the management style as well. In this regard, managers must adapt their strategies to introduce the changes in a proper way (Media-Partners, n.d.).
The manager may apply reinforcement and incentive methods, regulate the performance of the employees through communication strategies and motivation, utilize the techniques to optimize the work processes, and increase the responsibility of the staff through the corresponding initiatives. The practicum change is concerned with strategies to prevent pressure ulcers occur in intermediate patients at Kendall Regional Medical Center (KRMC), and it is essential to consider all the possible aspects of its implementation to ensure that the management staff will be able to execute the change in the most effective way.
Pressure ulcer (also referred to as pressure/bedsore, and decubitus ulcer) is an area of locally damaged tissue formed by unrelieved pressure. As a rule, it locates over a bony prominence (DeWit & Kumagai, 2014). Such ulcers may cause ischemia, necrosis, and cell death. Risk groups include patients of various backgrounds with varied health status. For instance, patients suffering from serious diseases or those having spinal cord injuries are among the representatives of the risk group. Moreover, patients, whose mobility is impaired, rather frequently develop pressure ulcers. The people who wear prostheses or a plaster cast and completely paralyzed individuals fall in the risk group as well.
It should be mentioned that patients with obesity or some other nutrition problems might also develop the disease (DeWit & Kumagai, 2014). Apart from that, older adults and pregnant women should be aware of the possibility to develop pressure ulcers due to decreased mobility and other health-related issues. In general, pressure ulcers can be caused by improper posture, which aggravates pressure on bones or some unsuitable equipment. It is assumed that the creation of a team of qualified specialists (staff nurses, nurse managers, nutritionists, pharmacists, physicians, and senior leader) that will have the necessary knowledge and expertise would allow furnishing more effective care and achieve better nursing and patient outcomes.
However, the successful implementation of the proposed change requires effective coordination and collaboration of the key stakeholders that include both the patients, their families, and the nursing team (DeWit & Kumagai, 2014). The core of the negotiation plan lies in a well-trained and equipped team and the active engagement of the stakeholders to achieve the desired outcome, which is the reduced occurrence of pressure ulcers.
It is assumed that the leadership of the KRMC is the main audience of the practicum project since it is the leading agent in the change management. The hospital leadership is liable for regulating the organizational and policy issues and administering the action plan for the staff, which is essential for the successful improvement of care provision in the center (Media-Partners, n.d.). The leadership is to eliminate the individualistic behaviors of the employees to ensure that the key stakeholders can collaborate efficiently. Regarding the negotiation plan, communication within the hospital must be organized in an orderly manner to facilitate the effective execution of the change management.
The success of change management directly depends on several external and internal factors. Thus, it is important to mitigate the possible barriers to the change in project implementation. Some of the barriers are related to patients. For instance, they should be knowledgeable of the risks of impaired mobility, and they should be informed about the preventive measures in due time. Further, the health care team should collect information about the patient’s condition related to pressure ulcers within the first 8 hours of his/her hospitalization to be able to eliminate the risk factors (Frontera, Silver, & Rizzo, 2014). Also, the team of specialists is to obviate the extrinsic factors that can cause pressure ulcers. Thus, the prevention of the disease requires effective communication skills of all the employees, the timely care provision and preventive measures, the specific training, expertise, and coordination of the nursing staff. The active collaboration and sharing of knowledge should be encouraged to achieve better patient results.
The objective of the change theory is to manage the implementation of the change project to prevent pressure ulcers in KRMC’s patients. In this relation, the concept of Lean focuses on the patients as a Quality Improvement Tool. This approach will allow assessing the needs of patients and determine the value (Scully & Wilson, 2014). The theory implies the elimination of non-value-added activities, which means avoiding the redundant actions that do not result in effective disease prevention. Moreover, the application of modern technologies will ensure the reduction in manual labor and eliminate wastes in the process. Most importantly, the Lean concept focuses on systematic improvement of care provision and preventive measures, which denotes the identification of root causes to prevent problems in perspective.
Proposed Change Strategies
The proposed change project is aimed at creating a team of qualified specialists (staff nurses, nurse managers, nutritionists, pharmacists, physicians, and senior leaders) and providing protective devices to ensure comfortable positioning and protection from the external risks (Sarasua et al., 2011). The employees will be involved in educational programs oriented at training them in the use of the technologies for prevention purposes. It is planned to conduct an in-depth study of the state of the environment, objectives, and developed project methods and adopt solutions for efficient use of available resources in the organization. An essential part of the strategy is changing the organizational culture of the KRMC.
The key stakeholders include both the patients and the KRMC team. The prevention of pressure ulcers should start with patients and their family members to ensure that patients themselves take preventive measures. In the case of paralyzed patients, the family should be liable for the implementation of preventive care. Further on, the team is one of the main stakeholders. The staff nurses, nurse managers, nutritionists, pharmacists, and physicians are involved in care provision for the patients, and they should be trained in effective practices including manual labor and modern technology. The team is responsible for monitoring the patient’s health status in terms of immobility, poor nutrition, dehydration, and so on. Consequently, proper training is necessary to ensure that the care provider is initiated within a reasonably short period. The team should be coordinated properly to avoid producing wastes in the process of furnishing aid.
The process of change will be based on a new approach to the management of the organization focused on quality improvement. The quality change will be achieved through the involvement of all personnel members as well as the key stakeholders. The principle of staff involvement will provide a permanent joint work of all employees of the organization to achieve the project objective, which is the prevention of the pressure ulcer (Sarasua et al., 2011). The involvement of staff can be reached after the employees will gain insights into the project and after the leadership will create the necessary working and educational environment.
Since the organization is composed of various specialized units, which have a vertical management hierarchy, these units will be connected through associated processes, which will provide the horizontal interaction. Thus, the processes will become part of the general processes of the organization. The practice of individual units will be integrated into larger ones throughout the center, and that will allow reaching the main strategic aim (Perry, Potter, & Ostendorf, 2015). Also, continuous permanent improvement will be conducted to enable the center to apply both analytical and creative methods of quality improvement. Also, during the change project, effective communication will play a significant role in maintaining motivation and awareness of employees at all levels of management. The communication on the changes must become a part of daily activities. Consequently, KRMC will promote the change project as a part of its formal and informal organizational culture through the application of the official policies and procedures.
Communication Plan and Negotiation Strategies
As stated earlier, effective communication and negotiation strategies are integral to successful change management. It is planned to provide informational and educational support to all the key stakeholders. The strategy envisages staff education on aspects of the project through mass communications and facilitation of their trust in the consistency of management actions. The internal network will allow two-way communication. For instance, meetings of managers with the personnel and coaching groups would enable exchanging ideas and sharing the knowledge on the preventive strategies (Scully & Wilson, 2014). Thus, the employees will receive the necessary information and will be able to ask questions or express their perceptions and suggestions.
Additionally, the plan includes collective group settings (personnel consulting) to gather the staff views and perceptions. Employee participation is indeed crucial for the center as it is a way to encourage them to make suggestions often in conjunction with introducing relevant policies and guidelines to educate the stakeholders about the implemented change. Finally, yet importantly, groups of workers, along with line managers will be able to examine thoroughly and develop ideas and processes related to the proposed project as well as to solve the emerging problems.
Pressure ulcers are an issue of paramount importance as they are associated with the risk of death if not addressed timely. The application of educational strategies for the key stakeholders as well as the introduction of modern technologies will facilitate the effective prevention of possible complications. The KRMC’s management has an important task to implement the change bearing in mind that the success of the project depends on numerous factors and forces that may interfere with its implementation. For that reason, the management must apply leadership to facilitate the change for achieving better patient outcomes.
DeWit, S., & Kumagai, C. (2014). Medical-surgical nursing. New York, NY: Elsevier.
Frontera, W., Silver, J., & Rizzo, T. (2014). Essentials of physical medicine and rehabilitation. New York, NY: Elsevier.
Media-Partners. (n.d.). What a manger should say [Video file]. Web.
Perry, A., Potter, P., & Ostendorf, W. (2015). Nursing interventions & clinical skills. New York, NY: Elsevier.
Sarasua, J., Lopez, S., Viejo, M., Basterrechea, M., Rodríguez, A., Gutiérrez, A.,…Hernández, O. (2011). Treatment of pressure ulcers with autologous bone marrow nuclear cells in patients with spinal cord injury. The Journal of Spinal Cord Medicine, 34(3), 301-307.
Scully, N., & Wilson, D. (2014). Clinical cases. New York, NY: Elsevier.
Kendall Regional Medical Center And Its Information Laws
Maintaining patients’ data safety has become increasingly topical and important in the context of the 21st century and the application of digital tools as the means of managing information. Seeing that hospitals keep a detailed record of not only their patients’ health issues but also their private data, it is imperative to make sure that the nursing facility in question complies with the current legal requirements for health informatics (HI) and has developed an appropriate framework.
Although the Kendall Regional Medical Center (KRMC) provides a detailed description of the data required from the patient, as well as explains to what use it will be put, the current policy clearly lacks the elements that would ensure patients’ personal information security. Therefore, a more elaborate approach toward data management should be designed (Mantas, Househ, & Hasman, 2014).
UK Health Regulations and the Rules of KRMC
A wide array of HI-related regulations has been passed over the past few decades. As the table below shows, the framework currently used at KRMC could be improved by focusing on ensuring the security of the patients’ personal data. Therefore, the approaches adopted presently in the facility will have to be modified so that a patient-centered framework could be designed.
Table 1. UK Healthcare Information Management Regulations vs. the KRMC Strategy
|Access to Health Records Act 1990:
Only health professionals have the access to the patient’s health record (Her Majesty’s Government, 1990).
|Facility personnel and the agents of the facility are entitled to accessing the patient’s data (Kendall Regional Medical Center, 2016).
|The terms “personnel” and “agents” should be defined in a more accurate manner so that only the members of the healthcare units could access the data.
|Data Protection Act (DPA):
DPA guarantees that the patient’s data should be used fairly and lawfully, as well as for limited purposes clarified specifically to the patients (Her Majesty’s Government, 1998).
|KRMC members are obliged to use the data that patients entrusted them with in a fair and lawful manner. More importantly, the facility does not seem to be eager to provide their patients with access to their medical records regularly (Kendall Regional Medical Center, 2016).
|KRMC clearly lacks the clarification phase. The organization members should be more specific when detailing the reasons for using patients’ private data and records information. Furthermore, it is desirable that the patients should be given an opportunity to revisit their health records.
|Patient Rights (Scotland) Act 2011
The legislation states quite clearly that no information “which would infringe patient confidentiality” (Her Majesty’s Government, 2011) should be provided to any third parties, even in case the patient is incapable of acting on their own (e.g., due to a severe mental or physical impairment).
|The representatives of the KRMC facility do not seem to have a lenient attitude toward the caregivers of patients with disadvantages. Specifically, the essential information from the patients’ records is provided to the caregivers only on demand (Kendall Regional Medical Center, 2016).
|The existing approach, though posing obstacles to the family members on their way to retrieving crucial information about the patients under their wardship (Corti, Van den Eynden, Bishop, & Woollard, 2014).
Although KRMC meets several criteria for personal information storage and management, it clearly fails to meet the needs of the patients by depriving them of an opportunity to check their records and carry out the related actions. The scenario that the members of KRMC are facing clearly is a prime example of trying too hard without evaluating the implications. Therefore, a more flexible approach with more concern for the needs of the target audience should be designed.
Corti, L., Van den Eynden, V., Bishop, L., & Woollard, M. (2014). Managing and sharing research data: A guide to good practice. Thousand Oaks, CA: SAGE.
Her Majesty’s Government. (1990). Access to Health Records Act 1990.
Her Majesty’s Government. (1998). Data Protection Act 1998.
Her Majesty’s Government. (2011). Patient Rights (Scotland) Act 2011.
Kendall Regional Medical Center. (2016). Note of privacy practices.
Mantas, J., Househ, M. S., & Hasman, A. (2014). Integrating information technology and management for quality of care. Washington, DC: IOS Press.