Delivering on the Promise of Structured Programs, Capstone Project Example

Problem

Staffing is an integral aspect of the quality of output realized in any given organization, relative to its industry within which it operates. Healthcare is an industry that is highly responsive to the quality of human resource that is employed to execute the different functions required. The healthcare industry is currently plagued with variability in the quality of healthcare rendered to patients. There is a general lack of uniformity in the quality of services that patients receive despite the set standards. This has been characterized by different levels of employee qualification, experience and satisfaction in different medical institutions. Staffing in mental health facilities reduce the quality of patient care. This is linked to the general differences in incentives that employees experience within the workplace. Incentives influence the ability of nursing staff to handle challenges faced when working with patient care.

The severity, frequency and number of medical errors within healthcare are a crucial indicator of the quality and performance of nursing staff within any given healthcare institution (Flynn, Liang, Dickson, Xie, & Suh, 2012). Healthcare has currently realized increased scrutiny on the medical errors that are committed by healthcare professionals. Existing educational and cultural support systems determine the number, frequency and severity of medical errors realized by nursing staff.

This has been compounded by the inappropriate allocation of nurse staffing resources, accentuating activities as opposed to meeting rising patient demands. This skewed allocation of resources causes internal systemic inefficiencies that have also been found to play a significant role in the high rate of nursing staff turnover that has characterized the nursing profession (O’Brien-Pallas, Murphy, Shamian, Li, & Hayes, 2010). There is a significant presence of conflict within the different functional units as a result of the ambiguity of roles and responsibilities of each functional unit and functional area. With numerous nursing functional areas experiencing overlaps in their functions, ambiguous roles and responsibilities that result from skewed allocation of nursing staff resources tends to cause frustration, mental health issues and anxiety amongst nursing staff. This has compounded the rate at which nursing staff turnover is experienced.

Intervention (Proposed Solution)

A human resource implementation plan is proposed to provide a solution to the problems and challenges that have been highlighted in the section above. Providing mental health nurses with enhanced training programs to help them cope with the challenges they will face, thereby decreasing the nurse turnover rate. Specifically, nurses will be provided with data that is pertinent to their individual health care facility so that they are aware of the individual needs of their patients. It is important that certain fundamental aspects be taken into consideration so as to; (1) improve the quality of healthcare services dispensed to patients, (2) mitigate the number of medical errors performed by the nursing staff, (3) enhance loyalty and improve staff motivation, (4) adequately allocate nursing staff resources, (5) adequately define functional roles and duties, and (6) mitigate nursing staff turnover (Flynn, Liang, Dickson, Xie, & Suh, 2012). This shall be achieved through the implementation of a number of policies and programs within the human resource department.

Capability Development

Organizations in the 21^st century are faced with the daunting task of hiring and retaining high quality, qualified and experienced staff. However, owing to the nature of business, an organization may alternatively opt to develop talent internally, increasing the value of its workforce from within (Sorrell, 2010). Such organizations foster a sense of belonging and ownership in its employees, enhancing employee satisfaction and loyalty.

Data-Based People Management

This largely entails the use of data to conduct people analytics so as to gauge employee performance and output. DBPM is developed to provide an objective perspective and outlook towards nursing staff performance (Conger, 2010). This is a critical monitoring tool that enhances the problem solving process within the organization.

Recruitment and Selection

This entails the rigorous process of identifying only the best individuals to take on open positions within the company. While capability development is an integral part of improving nursing staff performance, there is an inherent need to ensure experience and innovation within a healthcare institutions staff. This will be facilitated by a rigorous recruitment and selection process.

Technology

Technology seeks to enhance an employee’s or worker’s ability by making work much simpler and faster. Through technology, the elements of human error can be mitigated or averted by using computerized systems in the production process for goods and/or services (Hanrahan, 2009). This is essential for efficiency, the true measure of productivity. Technology helps an employee to produce more over a relatively short period of time, while reducing errors in the process. According to the information, technology is a requirement for productivity.

Rationale

The proposed human resource management policy and framework is integral to success of the modern day human resource department in the healthcare industry. Each component of the policy and framework has been developed to address the six key issues identified.

Capability development improves the quality of care dispensed to patients by ensuring more competent healthcare professional attending to the patients (Slizer & Dowell, 2010). With the ability of younger healthcare professionals to receive guidance and training from more experienced professionals, they gain hands-on knowledge on how to mitigate medical errors. This is also instrumental in mitigating staff turnover. Capability development is integral in employee retention in mental health institutions.

Kanter, in his theory of organizational structure development highlights the need to create a work environment that fosters growth and development. When leaders empower other individuals within the organization, an environment for growth is created. The proposed plan is in line with Kanter’s theory as it depicts the six preconditions of empowerment;

1. Opportunity for advancement
2. Access to information
3. Access to support
4. Access to resources
5. Formal Power
6. Informal Power(Kirwan, Matthews, & Scott, 2013)

There are two components of Kanter’s theory: The first one is based on the growth, mobility and chance to increase knowledge and skills and the second is the structure of power which refers to the ability to access and mobilize resources, information and support for one’s position in order to get a job successfully done.

Data-based people management is essential in identifying medical errors before they occur and develop ways to mitigate these errors. This is also integral in identifying the strengths of every given staff member to necessitate adequate allocation of staff. This is also the foundation of adequately defining the functional roles and duties of staff members.

A rigorous recruitment and selection is key to determining the quality of healthcare services patients receive. This quality is enhanced by the use of technology. Technological advancements enhance processes and procedures, mitigating errors associated with the human element.

Evidence in Literature

A rigorous staffing process is one of the assured techniques to ensure high quality healthcare services delivered to patients. According to How, L. (2013), inadequate staffing is found to be responsible for a reduced quality of patient care. In order to reduce turnover, employees require incentives that develop a sense of belonging and ownership (How, 2013). The literature further highlights the importance of enhanced training programs within the human resource department. Internal training programs are integral in developing the skills and ability to handle the challenges that the face working in patient care.

Flynn, Liang, Dickson, Xie and Suh highlight the causes of medical errors and the manner in which they are handled. The researchers conducted a study that revealed nurses have the ability to effectively intercept medical errors when they are provided with comprehensive educational and cultural support. This educational support is achieved through internal training and talent management programs (Flynn, Liang, Dickson, Xie, & Suh, 2012). This opinion is echoed by McAllister, Happell and Flynn’s research. Nurses are able to identify problems before they become severe when they have a conducive work environment (McAllister, Happell, & Flynn, 2014). This work environment can also be enhanced through the use of technology.

The lack of an adequate work environment has been attributed to high levels of nurse staff turnover. Research revealed that role conflict and role ambiguity is largely responsible. Defining the roles for each nurse is integral to developing an efficient and free-flowing system. This can be achieved through the application of an effective recruitment and selection process that employs staff according to the given roles and responsibilities.

Variability in the quality of healthcare is one of the most significant problems facing nurse staffing in the 21^st century. McDonough sheds light on the fact that staffing techniques currently employed directs bulk of nurse staffing resources for activities as opposed to meeting patient demand, which rises every passing day (McDonough, 2013). Optimally allocating resources requires the application of data-based people management techniques.

Employing internal talent pipeline management is integral in ensuring employees have the adequate incentive to provide the best quality of healthcare. This is in line with Redknap, Twigg, Rock and Towell’s research that highlights benefits and incentives as factors of continued effective performance.

Implementation Logistics

The implementation of the proposed plan will be executed in stages. While the stages are distinct, certain aspects of these phases recur across the board, and as such integration may be both sequential and simultaneous.

Change Management

The introduction of new technology, such as the Electronic Health Record (EHRs) can be faced with considerable resistance. This part involves the induction of all the physicians to the system to be used in the near future. The fact that the EHR is being developed does not guarantee its use in the clinical arena or the hospital. People may resist it due to lack of common benefit with the organization, lack of will to adapt to new work process and the fact that people conduct a cost-benefit analysis on the issue.

User training

Technology plays an integral part of delivering health services to patients. As such, there is a considerable need to develop a plan that ensures all employs develop the necessary technological aptitude to enhance accuracy. Mental health nurses employ a number of new technological innovations to enhance the management and treatment of mental disorders. Technological innovations such as Virtuality Realty Exposure Therapy (VRET) and mobile applications have become important complementary techniques for managing post-traumatic stress disorder (PTSD).

Other technology such as electronic health records (EHR) systems are currently the desired industry standard globally. As such, training on the features, functions and effective use of the EHR system is crucial. Perfect time has to be set and training done in groups to reduce cost, unless one- on-one experiments and explanations are necessary. In making the plan for the training process, decision of training and the actual training have to begin before the go-live period (lectures notes, EMI and change management strategies).  There should be selection of a group of staff members to go for training by the vendor. All staff are then tested for computer skill, and if they don’t have these essential skills, they should be trained first in this field. The cost of the training is then determined. Mode of training may include quality documentation trainings, tailored training, and instructor-led classroom training. In other cases, there may be computer-based training and independent lab exercise/ study.  The next step after training is assessment of the trained medical representatives.

Usability of Technology

Technology, an important factor of mental health services dispensation, can only be useful if its users find it usable. Technology such as the virtual reality system (used in VRET) and the EHR system have to be configured in a manner that it reduces amount of time required to accomplish a given task. This ensures that medical health professionals administer accurate diagnosis on mental health patients, and be able to detect anomalies that may lead to considerable implications on the patient’s mental health. In addition, it should offer a high degree of consistency in every intended aspect in the hospital. By reducing errors and enable multitasking.

Talent Pipeline Development, Recruitment and Selection

Retention of employees is paramount to ensuring consistent and sustainable growth. As such, taking advantage of the talent within the organization and nurturing it. Mental health practitioners that show the potential to develop innovative and revolutionary techniques to impact the industry should be nurtured (Wynn, 2013).

Mental health institutions and organizations should align talent pipelines to their talent management initiatives by employing a competency framework that maps strategic objectives to the standards of performance as well as the whole Talent Development framework stream of the organization (Greenberg & Sweeney, 2010).

The systematic processes involved in building talent with the mental health institution or organization entails:

• Identification of the human resource needs within the organization
• Identification of the talent management strategy and approaches the organization can employ
• Identification of the resources available to the organization to pursue the optimal talent management strategy that best suits the organization. This will involve determining the scope of the talent management strategy, its limits and its capabilities based on the resources, financial and man power, that is available to the organization.
• Identification of the employees that poses the potential and talent that is required within the organization
• Execution of the desired talent management strategy
• Re-evaluation of the talent management strategy (Conger, 2010)

Resources

The implementation of the plan is dependent on the availability of a number of factors that are critical for success. These factors include the resources required for the accomplishment of the plan.

Staff

This is the most important resource required. The plan has been developed and designed for nurse staff to develop the skills required to accomplish healthcare at the highest possible level. The organization requires employees within the organization as they formulate its internal pipeline. Their availability and willingness to participate in the program determines the level of success that can be achieved through the implementation of the plan.

Technology

Technology is an integral aspect of the plan, most of the improvements have been centered around, or complemented by technological aspects. The most significant is the computer hardware required to run the EHR.

Education Materials

One of the significant aspects of the plan is the introduction of internal improvement programs for the staff. There is need for the use of educational materials to facilitate the training programs.

Assessment Tools

There are a number of assessment tools that can be employed to ensure success of the plan. Talent management has become such an integral part of organizations today that there is need for regular SWOT analyses  (Silzer & Dowell, 2010). The use of SWOT analysis in talent management is to critically analyse the efficiency and effectiveness of talent management techniques that are being employed by any given company.

References

Conger, J. A. (2010). Developing Leadership Talent: Delivering on the Promise of Structured Programs. In R. Slizer, & B. E. Dowell, Strategy- driven talent management: A leadership imperative. Hoboken: John Wiley & Sons, Inc.

Flynn, L., Liang, Y., Dickson, G. L., Xie, M., & Suh, D. (2012). Nurses’ Practice Environments, Error Interception Practices, and Inpatient Medication Errors. Journal of Nursing Scholarship, 44(2), 180-186.

Greenberg, H., & Sweeney, P. (2010). Invest in your Best. T+D, 64(7), 56-59.

Hanrahan, N. P. (2009). Analysis of the psychiatric-mental health nurse workforce in the United States. Journal of Psychosocial Nursing & Mental Health Services, 47(5), 34-42.

How, L. (2013). The Impact of Nurse Staffing on Quality of Patient Care in Acute Care Settings: An Integrative Review Paper. Singapore Nursing Journal, 40(4), 10-23.

Kirwan, M., Matthews, A., & Scott, P. A. (2013). The Impact of the Work Environment of Nurses on Patient Safety Outcomes: A Multi-Level Modelling Approach. International Journal of Nursing Studies, 50(2), 253-263.

McAllister, M., Happell, B., & Flynn, T. (2014). Learning Essentials: What Graduates of Mental Health Nursing Programs Need to Know from an Industry Perspective. Journal of Clinical Nursing, 23(24), 344-359.

McDonough, K. S. (2013). Development of the McDonough Optimum Staffing Method: Evidence-Driven Recommendations Based on Patient Demand. Virginia Nurses Today, 21(2), 8-11.

Neville, C., & Goetz, S. (2014). Quality and Substance of Educational Strategies for Mental Health in Undergraduate Nursing Cirricula. International Journal for Mental Health in Undergraduate Nursing, 23(2), 128-134.

O’Brien-Pallas, L., Murphy, G., Shamian, J., Li, X., & Hayes, L. (2010). Impact and Determinants of Nurse Turnover: a pan-Canadian study. Journal Of Nursing Management, 18(8), 1073-1086.

Phillips, B. (2005). A Survey of Mental Health Nurses’ Opinion of Barriers and Supports for Research. Nursing Praxis in Inew Zealand, 21(2), 24-32.

Redknap, R., Twigg, D., Rock, D., & Towell, A. (2015). Nursing Practice Environment: A Strategy for Mental Health Nurse Retention. International Journal of Mental Health Nursing, 24(3), 262-271.

Roche, M., & Duffield, C. (2007). Issues and Challenges in the Mental Health Workforce Development. Contemporary Nurse: A Journal For The Australian Nursing Profession, 25(1), 94-103.

Slizer, R., & Dowell, B. E. (2010). Strategy-driven talent management: A leadership imperative. San Francisco: Jossey-Bass.

Sorrell, J. (2010). Retaining the Experts: Aging Nurses in Mental Health. Journal Of Psychosocial Nursing & Mental Health Services, 48(1), 17-20.

Stevens, J., Browne, G., & Graham, I. (2013). Career in Mental Health still an Unlikely Career Choice for Nursing Graduates: A Replicated Longitudinal Study. International Journal of Mental Health Nursing, 22(3), 213-220.

Thomson, L. A., & Hamilton, R. (2012). Attitudes of Mental Health Staff to Protected Therapeutic Time in Adult Psychiatric Wards. Journal Of Psychiatric & Mental Health Nursing, 19(10), 911-915.

Walker, E. R., Berry, F. W., Citron, T., Fitzgerald, J., Rapaport, M. H., Stephens, B., & Druss, B. G. (2015). Psychiatric Workforce Needs and Recommendations for the Community Mental Health System: A States Need Assessment. Psychiatr Serv, 66(2), 115-117.

Wynn, S. D. (2013). Addressing the Nursing Workforce Shortage: Veterans as Mental Health Nurses. Journal of Psychosocial Nursing Mental Health Services, 51(2), 3-4.