Nursing Leadership and Development, Research Paper Example

Professional and Personal Account.

Recognizing the need in the health care system for effective and organized leadership in order to make services more effective has made me choose the Chamberlain College of Nursing for gaining a Doctor of Nursing Practice (DNP) qualification. I looked at the course description of the college, and found that the  curriculum of the course was the most suitable for my goals: becoming an effective nursing leader, who is able to help the health care system in the process of transformation towards higher efficiency, availability, and the integration of evidence-based practice. My main personal goal is to improve patient outcomes within the health care organization, and I believe that through the DNP qualification, I will have the skills and competencies to make positive changes and influence the quality of care. Working as a nurse, I have seen several problems with health care service delivery, human resource planning, and the lack of integrating evidence-based practice in the clinical setting. I decided that I had a responsibility to learn as much as I could about effective health care delivery, in particular focus on disadvantaged and underserved populations. I also understood that learning the theories related to nursing leadership would not make me a better leader, therefore, chose the DNP program to get a chance for testing my knowledge in practice, during the Project & Practicum experience.

Changes I intend to Make after Graduation

While previously I did not understand the concept of population analysis, and the importance of evidence-based  practice, I believe that the studies in health policies, health care informatics, and population health outcomes have opened my eyes to a new way of designing treatment plans that respond to patient needs. During my time as a nurse, I studied several academic articles related to DNP training and found that I can improve the delivery of services within my nursing unit by becoming not only a nursing leader, but also a researcher. I started to implement research in my practice, and transform the unit into a more effective, more responsive, and patient-focused health care facility. According to Vincent et al. (2011), DNP leaders need to become practitioner-researchers, in order to bridge the gap between the findings of research studies and practice. After completing the DNP course, I feel like I am able to become one of these practitioner-researcher, who can support the implementation of more effective health care delivery approaches. I would also like to act as a facilitator for discussion and change within my new role, and the leadership/communication/research/analytical skills learned during the DNP course will enable me to do so. I will be able to utilize my research skills seeking out opportunities to collaborate with researchers and health care government agencies to work towards a shared mission.

DNP Preparedness and Role in the Health Care System

In my new role, I would like to be addressed as a clinical quality improvement manager by non-physicians, and service quality manager by physicians. As in my future career as a DNP qualified nurse, I would like to focus on transforming health care organizations to improve patient outcomes, efficiency, and compliance, I would like to be the person responsible for projects that address systematic shortcomings. This means that I will need to closely collaborate with both nurses and physicians, in order to achieve a full understanding of challenges and opportunities for improvement.

Ideal Position

Improving Cost, Quality, and Access

After researching related publications, I found that the most suitable position after graduation would be to become a quality improvement director in a community hospital. According to Nichols et al. (2014), DNP qualified nurses can get a position leading positive changes, transforming practice, and making service more available for the population served. The authors created a survey among advanced practice nurses, nurse practitioners, and nurse leaders, in order to assess the general concepts about DNP nursing leaders. 58.3 percent of the respondents stated that they would consider employing a DNP qualified leader as a quality improvement director. This role would enable me to look at the systems of health care delivery, create quality improvement projects, work closely with nursing leaders and physicians, while addressing the general and organization-specific challenges. I would also like to introduce service delivery measures, goals, and missions, monitor patient outcomes, and utilize surveys to identify the shortcomings of service delivery.

Fairbrother et al. (2014) created a comprehensive overview of tools that can be used to reduce health care delivery costs, while improving quality of service and patient outcomes. I would like to utilize comparative effectiveness research (CER) for developing projects focusing on service effectiveness and alternative new approaches. As the authors state, the main question of this type of research is: “does the treatment work better than alternatives?” (Fairbrother et al., 2014, p. 7). I would also conclude continuous patient-centered outcomes research (PCOR), in order to effectively assess evidence and make informed decisions related to treatment plans based on risks and effectiveness.

Implementation of Evidence Based Practice

In order to understand new trends, research findings, and trends in the health care system, in the future I would like to participate in PCORI resarch (Fairbrother et al., 2014), which provides quality improvement managers with data infrastructure, facilities, and focuses on priority health care areas, such as screening for chronic disease risk factors, new treatment options, and training choices to improve patient outcomes. Through the national (and often) international database analysis, I will be able to test the reliability of the evidence before implementing new projects.

Addressing Policy Changes

In my new role, I would like to build a close relationship with policymakers and government agencies, in order to fully understand government targets, funding criteria, performance expectations, and focus areas. One of the policy changes that is likely to be introduced in the near future is related to benchmarking services and increased availability of health care staff. As a result of the introduction of the Affordable Care Act, demand for primary and clinical care services has risen, and is likely to rise significantly in the future. However, policies focusing on program implementations to reduce readmissions, provide screening services for disadvantaged populations, and reduce recovery time are likely to affect my day-to-day decisions. I will seek collaboration with government agencies, researchers, and policymakers, in order to work together on identifying risk areas, and populations whose needs are not addressed. I will hope to participate in research projects that focus on health care delivery improvement, cost reduction, service level, and organizational effectiveness. By working together with researchers, I believe that I will be able to play an important role in improving health care policies, expanding access, reducing the barriers to access, and addressing the issues underserved and disadvantaged populations face today.  I would also like to focus on identifying risk factors in clinical settings (addressed or not addressed by policies), and explore possible ways of addressing them, based on evidence-based research.

Skills and Knowledge

Advantages of DNP Training and Skills Obtained

DNP training provides individuals with the skills to apply principles and introduce evidence based intervention methods. Unlike other courses, this enables me to put the knowledge into practice. I believe that the most important skill that I obtained during the study was related to researching studies and trials, and collaborating with policymakers, as well as the academic community. While interpersonal, communication, and leadership skills are important when trying to positively impact an organizational behavior, the availability to effectively utilize health care information systems, analyze data, and create quality improvement missions around which the projects are built around are the most important abilities of DNP nurses. I am now confident that I can effectively synthesize information to improve the population’s health outcomes.

Advantages of Being a Nurse Faculty Member Compared with Tenured Faculty Membership

According to Vincent et al. (2010), there are several differences between the competencies of DNP and PhD nurses. DNP courses are built around practicum projects, and the development of research skills. While research-focused faculty programs are built around gaining information, DNP  allows participants to learn how to use the information gained from the research and apply it in order to introduce evidence-based practice. As Vincent et al. (2010, p. 1) conclude: “the practice-focused doctorate has a stronger emphasis on EBP, evaluation, quality improvement (QI), and translational research, and a lesser emphasis on theory, meta-theory, and traditional research methods such as experimental and quasi experimental designs”..

Leadership and Politics: Essential Negotiation Skills

Compared with MSN and MPH course graduates, I believe that I will be able to become a policy advocate through close collaboration with researchers and government agencies. DNP graduates often participate in nursing organizations’ work (Mullin, 2015). I would also like to be involved in research by facilitating it within my own health care organization, to help researchers create recommendations for effective policies and policy changes.

Specialist in Quality Improvement

Through implementing research findings into quality improvement projects, I hope that I will be able to effectively analyze evidence and improve effectiveness, patient outcomes, service delivery, and cost effectiveness within my future organization.

Recommendations for Transforming the Future

Two Recommendations to Focus on

• Out of the eight recommendations (Institute of Medicine, 2011), I would like to focus on two areas:
• Recommendation 2: Expand opportunities for nurses to lead and diffuse collaborative improvement efforts
• Recommendation 7: Prepare and enable nurses to lead change to advance health.

In my nursing career, I have experienced that collaboration helps leaders develop plans that benefit all stakeholders and takes into consideration various points of views. In my future career, I would like to create project collaboration groups, in order to allow nurses, nursing leaders, physicians, researchers, and patient advocates to express their views on various health issues. As I would like to work in a clinical setting, I would also like to focus on helping patients manage their own long term chronic disease condition and prevent complications. In my previous career, I have seen many diabetes patients who were not aware of the risk of different related health conditions, and could not act responsibly to reduce their chance to get a serious complication. Further, by collaborating with research and clinical staff, implementing evidence-based practice will be easier, as nurses and physicians will have a higher level of commitment to a shared goal if they know the vision behind the introduction of the new intervention. At the same time, nurses and physicians are able to help criteria for identifying at-risk population, and developing a comprehensive coaching and training plan that helps develop effective strategies. In my future career, I would like to take a multidisciplinary approach towards quality improvement, focusing on both patient experience and health outcomes. Without collaboration, information available for designing a more effective health care delivery system would be limited.

The second area of focus I would like to build my career as a clinical quality improvement manager is to lead change to advance the health of the population served by the organization. Through the leadership and advanced communication skills learned during the DNP program, I will be able to become change facilitator and engage with colleagues, as well as stakeholders. I would like to take the approach of transformational leadership in my role, where the leader creates a vision based on shared assumptions and beliefs, and considers the individual’s motivation and preferences. I would like to focus on empowering and coaching team members in order to build organizational competencies that result in higher efficiency and overall better patient outcomes. I would like to be the leader who is able to inspire individuals in their career, provide them with personal development opportunities, and creates a vision that represents the interest of all stakeholders. Leading change will be a great responsibility, however, I would like to engage with followers, listen to different views on the same health related issue, and build a consensus for the next steps to be taken. This way, the organization will be able to face with internal and external challenges, such as tighter government regulations, and shortage of staff, compared with the high demand of specialized clinical services.

Adjusting Practice to Recommendations: Skills and Knowledge Implementation

I would like to focus on putting my leadership, management, research, and clinical skills into practice, in order to achieve better patient outcomes, and ensure a good quality of health care delivery. My knowledge about underserved and disadvantaged populations, as well as the cultural and social barriers of seeking medical health will help me design public health awareness programs in a clinical setting that will focus on patient education and prevention, as well as screening. I believe that in order to reduce health related costs and create health benefits for customers, community health care units should focus more on screening, scanning, and identifying at-risk population.

Thanks to the research and analytical skills obtained during my studies at Chamberlain College of Nursing, I will be able to implement evidence based practice in the organization, and design patient centered care that addresses individual needs, cultural barriers, fears, and misconceptions. In order to address issues that the population the organization serves, it is also important to build links with communities and patient advocacy groups. Developing quality and efficiency measures and targets in order to create a shared vision is essential, however, this should be based on a consensus. Apart from bringing together diverse, multidisciplinary project teams to develop quality, patient safety, and efficiency improvement plans, I am also intending to survey patients and clinicians on a regular basis.

Conclusion

I believe that the different skills (leadership, research, project management and implementation, collaboration, communication, and analysis) learned during my DNP course will enable me to make a difference for not only the organization that will employ me as a quality improvement manager and leader, but also help me became the initiator and facilitator of change focusing on patient safety, lower costs of care due to a greater focus on patient education and prevention, and stakeholder relationships. In order to implement patient centered care and evidence based practice in the health care delivery systems, I had to learn how to obtain, check, and analyze data, collaborate with physicians, patients, researchers, and policymakers. I also had to understand the importance of ethics, compliance, and individual consideration. The practicum and project modules of the course did not only make me understand how my knowledge fits into a health care management system, but also allowed me to put my knowledge into practice.

Instead of becoming a nursing manager, I decided to obtain a DNP diploma that enables me to design process improvement projects, collaborate with different stakeholders, and create interventions based on a shared vision of a multidisciplinary team. I believe that quality improvement is necessary in every health care organization, and this is why I would like to obtain a position of a quality improvement manager after graduation. In my team, I would like to engage with followers, based on the approaches of transformational leadership, and enable nurses in my team to lead positive change and improve the quality, safety, and efficiency of health care delivery. I would also like to build collaboration with policymakers and researchers, facilitating research focusing on evidence based practice.

References

Fairbrother, G., O’Brien, E., Pradhananga, R., & Chalkidou, K. (2014). Improving Quality and Efficiency in Health Care through Comparative Effectiveness Analyses: An International           Perspective.

Institute of Medicine (US). Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing. (2011). The future of nursing: Leading change, advancing health.        National Academies Press.

Mullin, M. (2015) DNP Involvement in Healthcare Policy and Advocacy. In: Chism, L. A. (2015). The doctor of nursing practice. Jones & Bartlett Publishers.

Nichols, C., O’Connor, N., & Dunn, D. (2014). Exploring early and future use of DNP prepared nurses within healthcare organizations. Journal of Nursing Administration, 44(2), 74-78.

Vincent, D., Johnson, C., Velasquez, D., & Rigney, T. (2010). DNP-prepared nurses as practitioner-researchers: Closing the gap between research and practice. The American Journal for Nurse Practitioners, 14, 28-34.