4 pages without the first page and references.
The nursing leadership committee of a community-based health center is concerned about recent indicators of lower than standard quality patient care from inpatient and outpatient data. The committee wants to have a high patient outcome and recognizes the need to address the following issues:
1. Using the most recent quarter of patient satisfaction surveys, the nurse leader of the inpatient facility informs the staff that satisfaction scores are below the mean for other inpatient facilities in the region (this information is provided by the contracted company who administers the survey). In particular, patients report low satisfaction with nurse-patient interaction. In the comments section, two common themes are: 1) complaints about “hardly ever seeing a nurse”; and 2) feeling unprepared to go home.
2. In reviewing the number and type of missed appointments for the past six months, the nurse leader of a community-based outpatient clinic notes that Hispanic patients are 3 times more likely than Caucasian patients to miss their scheduled appointments. The nurse leader confers with the head of the pharmacy that is part of the clinic and discovers that, likewise, Hispanic patients are the least likely of all racial/ethnic groups to get their medication refills.
3. Likewise, the most recent data from the annual Human Resources Department indicate low job satisfaction among RNs throughout the health care center. Specifically, most of the RNs report being overwhelmed by the amount of “paperwork” and performance of non-nursing duties. There are also several comments from RNs related to dissatisfaction with the number of agency, “travel”, and PRN nurses that are used. For example, one comment states, “Not a week goes by where I am not orienting someone new to the unit.”
Issue/Problem: Changes need to be made to increase patient satisfaction with nursing care and increase RN job satisfaction. A disparity exists between Hispanic patients and Caucasian patients in terms of adherence to scheduled medical appointments and medication.
Assignment: Choose the major elements/factors/things/processes that can be changed that would affect both patient satisfaction with nursing care, and RN job satisfaction. Design a program/process that increases adherence to medical appointments and medication among Hispanics receiving care from the clinic.
To consider:
What additional information do you need to assist in making decisions (remember to create this information if needed)? What are the requirements and implications regarding the Affordable Health Care Act? What would you change? Share the reasons that you chose these changes? How will changing these make a difference? How do you go about implementing these changes? How can these changes be sustained? What barriers might you encounter when making these changes? What reactions would you anticipate encountering these barriers? How would you overcome the barriers? What additional information do you need to assist in making decisions (remember to create this information if needed)? What are the potential causes of the disparity? Identify the stakeholders in this community issue and the reasons you chose them. What is your program/process likely to address to decrease the disparity?
