D156 Leadership and Management E-Portfolio Template

D156 Leadership and Management E-Portfolio Template

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Name

 Western Governors University

D156 Business Case Analysis for Healthcare Improvement

Prof. Name

Date

D156 Leadership and Management E-Portfolio Template

Instructions for Course Deliverables

To fulfill the course requirements, students must complete the CPE Record by following the guidelines specified in the Assessment Task Overview. This e-portfolio should include all required deliverables along with reflective writings. Students have the option to input reflections directly within this template for each project phase or upload pre-prepared Word or PDF documents by following these steps:

1. Place the cursor where the content should be inserted.
2. Click on Insert, then select the arrow next to Object.
3. Choose Text from File.
4. Locate and double-click the desired file.
5. Repeat these steps for any additional documents.

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CPE Table: Estimated Time and Completion Dates

Deliverable	Estimated Time to Complete	Date of Completion
CPE Table	10 minutes	8/31/2024
Individual Stakeholder/Team Member Table	10 minutes	8/31/2024
Needs Assessment	1 hour	8/31/2024
SWOT Analysis	1 hour	8/31/2024
Impact Analysis	1 hour	8/31/2024
GoReact Screenshots/Posts	1 hour	9/1/2024
Video Reflection	30 minutes	9/1/2024

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Stakeholder Table

Role
Director of Patient Clinical Outcomes
Director of Informatic Services
Director of Medical-Surgical Department
Manager of Post-Surgical Units
Manager of Medical Units

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Needs Assessment and SWOT Analysis

What are the key issues identified in the needs assessment?

The needs assessment revealed a troubling increase in patient falls during shift changes within medical-surgical units, occurring both with and without injury. These incidents primarily happen during handoffs, especially when reports are conducted away from the bedside, often at nursing stations. Several critical factors contribute to this problem:

• People: Nurses and Assistant Clinical Nurse Assistants (ACNAs) frequently perform shift reports away from patients, limiting direct observation.
• Environment: High patient acuity combined with cluttered rooms filled with medical equipment obstructs staff visibility and awareness.
• Process: Staffing shortages and competing priorities divert attention away from patient safety.
• Interventions: Existing policies and procedures related to fall prevention require reassessment to improve effectiveness.

What interventions are planned to address these issues?

To mitigate these challenges, several strategies are proposed:

• Transitioning to bedside reporting to enhance visibility and safety during shift changes.
• Providing comprehensive staff education on the benefits and importance of bedside reporting.
• Delegating non-clinical tasks to unit secretaries, thereby allowing nursing staff to focus more on direct patient care.

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SWOT Analysis Summary

Category	Details
Strengths	1. Strong leadership support for bedside reporting implementation.2. Existing policies that endorse fall prevention.
Weaknesses	1. Limited staff knowledge about bedside reporting’s impact on fall reduction.2. Staff resistance due to concerns about increased workload and time demands.
Opportunities	1. Support from nursing departments for bedside reporting.2. Formation of fall prevention workgroups to monitor progress and share best practices.
Threats	1. Potential staff non-compliance and resistance to new procedures.2. Management concerns regarding possible overtime and enforcement difficulties.

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Impact Analysis

What benefits can be expected from implementing the improvement project?

The expected benefits are grouped into organizational and nursing-related categories, each rated on a scale of 1 (low impact) to 3 (high impact):

Category	Benefit	Impact Rating
Organization	1. Decreased patient falls during shift changes.2. Lower costs due to fewer complications and shorter hospital stays.	23
Nursing	1. Enhanced efficiency and safety on patient floors.2. Improved prioritization of patient needs and higher patient satisfaction.	23

Total Benefits Score: 10

What risks might the project pose?

The risks associated with the project, also categorized by organizational and nursing factors, include:

Category	Risk	Impact Rating
Organization	1. Resistance from staff due to increased workload perceptions.2. Potential longer shift handover times causing overtime.	32
Nursing	1. Staff discomfort in discussing sensitive information at the bedside.2. Insufficient education weakening staff engagement and effectiveness.	12

Total Risks Score: 8

What is the overall impact ratio, and what does it indicate?

The impact ratio is calculated by dividing the total benefits score by the total risks score:

[
text{Impact Ratio} = frac{10}{8} = 1.25
]

An impact ratio greater than 1 suggests that the benefits of the bedside reporting project outweigh its risks. This indicates that the implementation of bedside reporting is a promising approach to reduce patient falls and improve safety during shift changes.

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Video Reflection Summary

Engagement with stakeholders and the clinical preceptor highlighted the urgent need to reduce falls occurring during shift changes. It was noted that about 3% of patient falls in medical-surgical units happen during this transition period, often because reports are performed away from the bedside.

The current handoff approach limits nurses’ ability to closely observe patients, as their attention is divided among reporting, responding to alarms, and managing call lights. Moving to bedside reporting allows for direct patient assessment, which supports prioritizing care and identifying safety hazards more effectively.

The ultimate aim is to reduce falls by adopting bedside reporting. The needs assessment, supported by a fishbone diagram identifying factors across people, environment, process, and interventions, substantiates this approach.

The SWOT analysis pointed to strong managerial backing and existing policies as strengths, while staff resistance and knowledge gaps emerged as weaknesses. Opportunities include nursing support and fall prevention workgroups, whereas threats involve compliance challenges and confidentiality concerns during bedside discussions.

Impact analysis showed a positive balance between benefits and risks, with outcomes such as fewer falls, reduced hospital stays, cost savings, and enhanced patient satisfaction. Despite risks like resistance and possible overtime, these are considered manageable.

Overall, the project presents a valuable initiative for enhancing patient safety and improving nursing care practices during shift handovers.

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References

Institute for Healthcare Improvement. (2020). Patient safety and fall prevention. https://www.ihi.org/resources/Pages/Tools/PreventingPatientFalls.aspx

Joint Commission. (2019). National patient safety goals. https://www.jointcommission.org/standards/national-patient-safety-goals/

D156 Leadership and Management E-Portfolio Template

Tucker, S. J., & Spear, S. J. (2018). Improving nursing shift handoff through bedside reporting: A patient-centered approach. Journal of Nursing Care Quality, 33(1), 27–33. https://doi.org/10.1097/NCQ.0000000000000275

Wong, C. A., Laschinger, H. K., & Cummings, G. G. (2019). The impact of bedside handover on patient safety: A systematic review. Nursing Outlook, 67(2), 136–145. https://doi.org/10.1016/j.outlook.2018.11.0031

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