Concept Application Project: Leadership

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Kayleigh Alegria, Abi Anderson, Brianna Goodwin, Anna Masciola, Kaylee Smith

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Overview of Patient Care Delivery System

� Carondelet St. Joseph’s Hospital

Tucson, Arizona
o Couplet Care

o Focus: Improving communication between

manager and staff nurses about unit changes

and nurse expectations and requirements.

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Microsystem Model: Leadership

� Quantum leadership: “suggests that the environment

and context in which people work is complex and
dynamic and that this has a direct impact on
organizational productivity.”
� Based on transformational theory, leaders work with
subordinates to:
o Identify common goals
o Exploit opportunities
o Empower staff to make productive decisions
Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in nursing: Theory and
application (9th ed., p. 72). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
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Microsystem Mode: Organizational Culture and Support

� St. Joseph’s organizational mission states the facility serves

populations “by embracing the whole person in mind, body, and
spirit… serving all persons without distinction… and [providing]
an exceptional environment for our employees…guided by five
core values: quality, integrity, service, innovation,
transparency”.

Carondelet Health Network. (2019a). Leadership team at Carondelet Hospital. Retrieved from
https://www.carondelet.org/about-us/leadership-team

Carondelet Health Network. (2019b). Mission, values and values. Retrieved from https://www.carondelet.org/about-
us/mission-vision-values 4
Microsystem Model: Organizational Culture and Support

� The organization’s leaders “strive for excellence, innovation

and accountability in all areas of care”.
o No huddle, instead: mid-shift meeting
o Shift change: techs and clerks at 6, nurses and CNLs at 7
o Management meetings with staff as needed

Carondelet Health Network. (2019a). Leadership team at Carondelet Hospital. Retrieved from
https://www.carondelet.org/about-us/leadership-team

Carondelet Health Network. (2019b). Mission, values and values. Retrieved from 5
https://www.carondelet.org/about-us/mission-vision-values
Microsystem Model: Patient Focus & Staff Focus

� Patient Focus: “We follow an approach known as couplet care

that assures you and your baby are able to stay together as
much as possible to help deepen your bond.”

� Staff Focus: “We foster a culture of service that values

teamwork and focuses on the needs of others… a culture of
innovation that enables us to create strategies to address the
challenges and opportunities that arise in healthcare”
Carondelet Health Network. (2019b). Mission, values and values. Retrieved from
https://www.carondelet.org/about-us/mission-vision-values
Carondelet Health Network. (2019c). Careers. Retrieved from 6
Microsystem Model: Interdependence of Care Team

� Care teams that are successful in delivering patient

centered care have “mutual trust… present between
managers and employees”.
� Effective communication, adequate support, and staff
empowerment are crucial to a cohesive team approach.
o Provider rounding, nurse involvement
o Voceras

Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in nursing: Theory and
application (9th ed., p. 327). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. 7
Microsystem Model:
Use of Information and Healthcare Technology
� “As a communication tool, the internet provides access
to email, file transfer protocol, and the World Wide Web.”

○ Email underutilized for informing staff

○ Voceras used to communicate between staff
○ Cerner Charting System, and paper charting
○ Desk phones
Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in nursing: Theory and
application (9th ed. p. 507). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.

8
Microsystem Model:
Process for Healthcare Delivery Improvement
� “Because TQM is a never-ending process, everything
and everyone in the organization are subject to
continuous improvement efforts.”
� Bullet List
o CNL auditing
o Professional development incentive
o Online computer training each month

Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in nursing: Theory and
application (9th ed. p. 622). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. 9
Microsystem Model: Staff Performance Patterns

� “Performance focuses on patient outcomes, avoidable

costs, streamlining delivery, using data feedback,
promoting positive competition, and frank discussions
about performance.”
� Unit Performance Measurements:
o Readmission Screening
o OB Sepsis Screening
o Hourly Observation/Discharge Rounding

Reference 10
Specific Aspect Targeted for Improvement

� Area of improvement: manager communication

regarding information such as annual evaluations, policy
roll out, and unit improvement projects.

� Evidence based: Exploring communication processes in

workplace meetings: A mixed methods study in a
Swedish healthcare organization.

� Integrative nursing focuses on the health and wellbeing

of caregivers as well as those they serve 11
Specific Aspect Targeted for Improvement

� Integrative care modality: staff feedback and manager

reflection on effectiveness of communication

� Rationale: Patient safety and well being is affected by

staff safety and well-being which can be enhanced by
clear manager communication.
Bergman, C., Dellve, L., Skagert, K. (2016).Exploring communication processes in workplace
meetings: A mixed methods study in a Swedish healthcare organization. IOS Press Open Library,
54(3). 533-541. doi: 10.3233/WOR-162366
Kreitzer, M. J. (2015). Integrative Nursing: Application of Principles Across Clinical Settings. Rambam
Maimonides Medical Journal, 6(2). doi: 10.5041/RMMJ.10200
Leading the Plan for Healthcare Delivery Improvement

� Identify need for improved communication and present

evidenced-based study to management
� Begin holding meetings, as informed by evidence, for
communication topics instead of via word of mouth
� Provide monthly meetings about unit changes or
updates, meetings held on weekday, one day-shift
meeting (0730-0830) and one evening meeting (1930-
2030)
� Post-implementation survey
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Timeline of Events

1-2 months: Identify problem by evaluating effectiveness of

communication via survey and face-to-face staff feedback.
Educate unit manager on evidence-based communication
methods.

3-4 months: Design Unit Leadership/Management meeting

schedule and arrange organizational structure for meetings.
Timeline of Events Cont.

5-6 Months: Provide communication meetings once per

month to staff about new policies, policy changes, pertinent
evaluations

9 months: Require staff to complete surveys about meeting

effectiveness for improving communication, and implement
on unit long-term based on survey data
Bergman, C., Dellve, L., Skagert, K. (2016).Exploring communication processes in workplace meetings: A
mixed methods study in a Swedish healthcare organization. IOS Press Open Library, 54(3). 533-541. doi:
10.3233/WOR-162366
References
Bergman, C., Dellve, L., & Skagert, K. (2016). Exploring communication processes in workplace
meetings: A mixed methods study in a Swedish healthcare organization. IOS Press Open Library,
54(3). 533-541. doi:10.3233/WOR-162366

Carondelet Health Network. (2019a). Leadership team at Carondelet Hospital. Retrieved from
https://www.carondelet.org/about-us/leadership-team

Carondelet Health Network. (2019b). Mission, values and values. Retrieved from
https://www.carondelet.org/about-us/mission-vision-values

Carondelet Health Network. (2019c). Careers. Retrieved from

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References

Foster, T.C., Johnson, J.K., Nelson, E.C., & Batalden, P.B. (2007). Using a Malcolm
Baldrige framework to understand high-performing clinical microsystems. Quality and safety
in health care, 16. 334-341. doi: 10.1136/qshc.2006.020685

Kreitzer, M. J. (2015). Integrative Nursing: Application of Principles Across Clinical Settings.

Rambam Maimonides Medical Journal, 6(2). doi: 10.5041/RMMJ.10200

Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in
nursing: Theory and application (9th ed.) Philadelphia: Wolters Kluwer Health/Lippincott
Williams & Wilkins.