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Strategic Planning for Environmental Analysis

Strategic Planning for Environmental Analysis

Sample Answer 

Strategic Planning for Environmental Analysis

Background of the Project

According to Davidson, Aslakson, Long, Puntillo et al. (2017), Family Centered Care is adopted as a care philosophy for pediatric nursing. FCC provision implies that a physician incorporates conviction and knowledge in caregiving that the family is the constant aspect in the lives of children. Children are impacted by those who have a relationship with them even as they, too affect the latter. When families are included in the processes of care, then children are bound to access care of the highest quality Davidson et al., (2017). At the healthcare centre where the project will be implemented, formally adopting the philosophy of FCC in the NICU will serve to provide a framework for the neonatal nurse to take responsibility and work toward the goal of neonatal care in collaboration with the neonatal parents. This kind of care will be one that promotes and supports physical health as well as psychological and emotional development that takes place in the family context. Resident pediatric training does not offer all the required and necessary skills for practice. That said, a strategic plan needs to be implemented to ensure the proposed project is implemented and supported at the healthcare centre. This paper uses Issue-Based strategic planning based on the SWOT analysis carried out earlier.

Issue-Based Strategic Planning and Justification

Issue Based strategic planning is selected for this program’s implementation because the former is more dynamic and fluid compared to other strategic plans. This approach focuses on recognizing the diverse external and internal factors that affect an organization’s capacity, or in this case, the healthcare facility, to achieve its goals. The strategic plan involves finding a factor that holds the organization back from achieving its mission and vision or which could be leveraged to create benefits for the healthcare facility (Bryson, 2018). The SWOT analysis carried out earlier indicates the areas of weakness and the current threats that the organization faces. Additionally, the strategic plan directs on how to overcome any issues that may be hindrances to goal achievement and take advantage of the circumstances. Further, the strategic plan allows for adjustment of the mission of the organization if the factors are sufficiently significant for this to be done. The process will be repeated every few months to ensure that the strategic plan is effective.

At the healthcare facility where the project will be implemented, pre-interviews with mothers have shown that mothers have actively sought to collaborate with NICU staff in caring for their infants. This was challenging because for this to succeed, mothers need to work toward increasing their authority in the midst of power differences between themselves and healthcare professionals in a NICU environment. Healthcare professionals have control over infant care as well as the interactions between the healthcare professionals and the infants. Mothers have reported encountering numerous barriers when attempting to develop professional relationships with the nursing staff. Some of the barriers include a lack of time to communicate with nursing staff because of understanding, which prevented nurses from having adequate time to speak with mothers; having multiple healthcare givers, which prevented mothers from building rapport with any of them; and fear by mothers that their individual actions would be detrimental to the newborn’s health. Mothers also reported that their attempts at developing partnerships were either misunderstood or ignored, as they were interpreted as questioning the nursing staff’s competence.

Nurses, on the other hand, have had a shortage of staff, and this has made working schedules very tight. The time to communicate with neonatal parents has become a challenge as the nurses look to complete their shifts, having done as much as they ought to. Additionally, some nurses in the pre-interview stage pointed out that the hospital policy of ‘no distractions’ during medication administration ought to be extended to neonatal parents. Some nurses added that when administering medication, they have had near misses on medication errors when they were interrupted by neonatal parents asking questions concerning their infants. The nurses were concerned that creating collaborations with the parents would slow down their work or create conflicts with mothers who believed their infants needed to be taken care of in a certain way.

Goals of the Project

Applicability in The Ethical Environment; Cultural Environment; Use of Technology; And Health Care Policies, Laws, And Regulations

As mentioned in the first part of this project, the goals of the programs are three. The first and second goals are short-term and will be to improve communication between nurses and the neonatal parents and ensure that the neonatal parents’ emotional and psychological needs are met. The third goal, and one that is long-term, will be reducing the nurse workload by increasing the number of staff at the NICU. The project’s objective will be to ultimately improve neonatal parents’ and nurses’ job satisfaction. In aligning with the ethical and cultural goals of the organization, the strategies will ensure inclusivity and staff diversification to meet the needs of the neonates and their parents.

The neonatal parents come from diverse cultural and religious backgrounds. Having a child at the NICU can be a very stressful time, and from observation, many parents turn to their religious beliefs for the well-being of their babies. In some incidences, some nurses had had conflicts of sorts when the parents attempted to hang religious paraphernalia on the cots of their babies. For example, some parents have attempted hanging Catholic rosaries believing that St. Mary and St. Thomas would intercede for their babies’ recovery; others have attempted to draw dark circles on their babies’ foreheads, while yet others have attempted to tie garlic wrapped wrist bands as a way to ward off the evil spirits that hinder their babies’ health. Needless to say, this has brought conflict at the NICU as nurses remove such paraphernalia, and in turn, neonatal parents feel offended, emotionally confused, and hopeless.

While nurses are empathetic toward parents and understand the drive to have such religious paraphernalia, these items pose a major health risk for already fragile patients. Further, nurses have complained that having to deal with these items and the parents that insist on having them on their babies’ cots not only wastes the nurses’ working hours as they try to talk sense to the parents and explain the dangers of such items, but are a distraction to the healthcare team and a source of distress to the patients. Thus, to address these scenarios, the project aims at having religious leaders as part of the care team and who will be assigned specifically to the NICU. The healthcare facility already has an in-house chaplain but does not have a Muslim or Hindu religious leader. When these are assigned to the NICU, parents will be informed of their availability, and they can talk to them and find spiritual counselling coupled with emotional counselling. The healthcare facility also has an in-house psychologist assigned to the pediatric ward. The project will propose that a psychologist be assigned to the NICU. The psychologist will need to be well-versed in cultural norms in handling different kinds of parents. The estimated time it will take to have this new staff is approximately three months. This is because the proposal has to be drafted and presented to the department head, who will in turn, hand it over to the hospital HR. The proposal will need to be reviewed, and at this time, two months will have passed. The last month will be spent on recruiting professionals in the discussed categories.

The other short-term goal is to improve communication between neonatal nurses and parents. The idea that a parent can talk to the same nurse is unrealistic because of the 12-hour shifts that staff work; they have off days, or are assigned to another patient to accommodate the unit’s integrity and workflow. First, to respond to these changes is the introduction of safe zones where nurses can reconstitute the medication to give to the patients without the interruption of parents or staff. Also, when administering medication, nurses will wear sashes of a specific color and which indicates that the nurse is not to be interrupted by parents or other staff. Taking these two steps will minimize distractions and increase patient safety by eliminating avoidable medication errors. After administering the medications, the nurses will then remove the sash, and this will indicate to the neonatal parent that he can then communicate with the nurse. In the area of improving communication, the parents will also be given access to the neonates’ Personal Health Records (PHR). The PHR information will be accessible via any smartphone and which will give updates on the vital health parameters and interpretation of the same. For example, a neonatal parent will be in a position to see how the baby’s blood pressure, weight, and temperature, among others, progress. This information is available in the NICU EHR and can be made available to the parent. This information is likely to reduce anxiety in the parent as the parent will monitor the neonate’s progress via a mobile device (Evans, 2016). Additionally, the parent will not have to ask the same questions over and over again, to a stretched-out nurse. The parent will only need to ask questions whose information is not captured in the PHR.

Secondly, and on the same note, the nurses will be required to go for a 1-week training on how to handle questions in a brief and empathetic way in answering the parents. A sort of script for the ideal, satisfactory, empathetic answers to the frequently asked questions will be availed to the nurses. Having specific answers that are to the point and delivered in a caring manner will allow for consistency even as different nurses attend to the same patient during different working shifts (Umberger, Canvasser, & Hall, 2018). Nurses will also be tasked with informing new parents on the meaning of the demarcated safe zones and the sashes they wear. Further, new parents will be required to visit with the NP that heads the NICU. In the first meeting, the NP will, in an empathetic manner, inform the new parents about their baby’s condition, what to expect during the baby’s stay, and then answer any questions they may have. The NP will also hand the new parents a pamphlet with on-point information on what they have discussed orally and also access to the PHR. Doing so will greatly minimize the number of questions and anxiety that the parents will ask and feel. The NP will communicate clearly and assuringly the competence of the staff caring for the neonate in order to give the new neonatal parents some form of courage and hope. The training will be repeated every four months to ensure that any changes are addressed, better communication avenues are developed, or the current ones are polished to perfection.

The last goal is to increase the number of staff at the NICU. This is a long-term goal as it falls under the larger organizational goals. Prior to having permanent employees join the NICU team, which solely lies within the authority of HR, the NICU will request to have volunteers and ‘comforters’ working at the NICU. The volunteers need to be versed in NICU protocol and will be tasked with communicating any information to the parents from the care staff. They will also play the role of comforter/listener; their job is to spend time with distressed parents and lend a listening ear and rend words of comfort to them. This goal is supported by the two short-term goals of improving communication and ensuring parents’ emotional and psychological needs are met. This goal will be on a continuous basis as the NICU seeks to advertise for volunteers who will work for a minimum of 3 months. High school students seeking to pursue a career in the healthcare field will be invited to volunteer during summer breaks. University students in the healthcare field as well as senior citizens seeking to keep themselves busy will also be invited to volunteer. Additionally, the NICU will send proposals to the head of the department to increase the number of permanent employees. Again, this will take approximately three months to hire new staff. Currently, the NICU is in need of approximately 12 new staff, and as it is, the healthcare facility is not likely to hire this number at once. Therefore, the proposal will seek to request 3 new additional staff after every 6 months. In a span of 2 or so years, the department will have the NICU have the desired number of staff. The same will be repeated every year to cater for events such as promotions and resignations, among others, that will create shortages.

In implementing the project’s goals, some regulations will be adhered to, specifically the HIPPA regulation on patient records safety. The privacy rule protects the privacy of specific, individually identifiable information referred to as protected health information, which is created and maintained by entities covered by HIPPA (Rouse, 2017). The covered entities include health plans as well as healthcare providers that transmit in electronic format any information connected with certain transaction standards, for example, healthcare claims.

Relevant Leadership and Health Care Theories

In implementing these changes and ensuring that the goals are attained, the preferred leadership theory will be transformational. According to this theory, the focus will be on transforming the team members, in this case, the nursing staff, to offer support to each other and the organization as well. The NP hopes that in using this theory, the team members will respond by feeling respect, loyalty, admiration, and trust and will be more willing to work even harder and exceed expectations (Fischer, 2016).

Three nursing theories are applicable in this project: Peplau’s interpersonal relations theory, Neuman system’s model, and Watson’s theory of caring. In this case, the theories focus on neonatal parents as those needing to apply the theories. In line with Peplau’s (2014) theory, the experiences that the neonatal parents go through will be the focus, as well as the perceptions they have on the care their neonates receive from the nurses. The Neuman systems model is based on the stress that the patient, in this case, the neonatal parents, experiences and how they react. The project will aim to reduce these stressors and help neonatal parents adapt to the environment and walk with their babies through the recovery process (Turner & Kaylor, 2015). Lastly, the Jean Watson theory of caring will also come into play as the nurses actively show they care for the patient and the neonatal parents through intentionality and authentic presence. The first meeting with the NP for new neonatal parents, the presence of volunteers, the psychologist, and the religious leaders are all part of the team that will work at putting these theories into practice for enhanced neonatal parents’ satisfaction, better job satisfaction for the nurses, and better patient outcomes (Watson & Woodward, 2020). That said, no better theories can be applied in the short- and long-term goals as these three theories cover every area of the goals, are bound to give the best outcomes, and are applicable in every dimension of the project.

Leadership Quality and Skills

Communication is the most vital skill that the NP as a leader, will need to have. The success of this project depends heavily on how and when communication is made. The NP as a transformational leader, should offer guidance and be an example of open and, honest, timely communication (Parker, Kunde, & Zeppetella, 2017). The other critical quality is being empathetic to the neonatal parents and the nurses without bias (Terezam, Reis-Queiroz, & Hoga, 2017). Nurses have expressed their frustrations, and so too, have the neonatal parents. The NP should not show favouritism to one side but instead implement the project without leaning on one side at the expense of the other. To ensure this is possible, the NP will require that feedback be given at the end of the shift on the experiences that nurses had. On the other hand, parents will also be welcome to give feedback at any time. Robbins and Davidhizar (2020) add that positivity is another skill that the leader needs to possess, even if the leader encourages team members to work with diligence despite disappointments or setbacks. Lastly, the NP should delegate duties and appoint change champions to ensure that all team members in the different shifts are on the same page regarding the changes’ implementation (Robbins & Davidhizar, 2020).

References

Bryson, J. M. (2018). Strategic planning for public and nonprofit organizations: A guide to strengthening and sustaining organizational achievement. John Wiley & Sons.

Davidson, J. E., Aslakson, R. A., Long, A. C., Puntillo, K. A., Kross, E. K., Hart, J., … & Curtis, J. R. (2017). Guidelines for family-centered care in the neonatal, pediatric, and adult ICU. Critical care medicine45(1), 103-128.

Evans, R. S. (2016). Electronic health records: then, now, and in the future. Yearbook of medical informatics, (Suppl 1), S48.

Fischer, S. A. (2016). Transformational leadership in nursing: a concept analysis. Journal of advanced nursing72(11), 2644-2653.

Parker, D. W., Kunde, R., & Zeppetella, L. (2017). Exploring communication in project-based interventions. International Journal of Productivity and Performance Management.

Peplau’s, H. E. Interpersonal Relations Theory. Nursing Inquiry2014, 21-4.

Robbins, B., & Davidhizar, R. (2020). Transformational leadership in health care today. The Health Care Manager39(3), 117-121.

Rouse, M. (2017). HIPAA (Health Insurance Portability and Accountability Act).

Terezam, R., Reis-Queiroz, J., & Hoga, L. A. K. (2017). The importance of empathy in health and nursing care.

Turner, S. B., & Kaylor, S. D. (2015). Neuman systems model as a conceptual framework for nurse resilience. Nursing science quarterly28(3), 213-217.

Umberger, E., Canvasser, J., & Hall, S. L. (2018, February). Enhancing NICU parent engagement and empowerment. In Seminars in pediatric surgery (Vol. 27, No. 1, pp. 19-24). WB Saunders.

Watson, J., & Woodward, T. K. (2020). Jean Watson’s theory of human caring. SAGE Publications Limited.

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