In assessing the political landscape at Adelante Healthcare, traditional power dynamics exist as seen in the traditional organizational chart with the Chief Executive Officer at the head of the company. Along with this, however, is a strong display of informal power lines. Many of the executive leaders have built strong relationships with their peers, direct reports, and community contacts which, in turn, has built deep bonds of trust and respect. Understanding these power dynamics is crucial when considering change theories, policy recommendations, and/or quality improvement projects as these key stakeholders can help garner support and leverage resources that project leads may not otherwise have the access or capability to do.
Alongside the leveraging of key stakeholder support, the application of Lewin’s Change Theory could be a practical advantage. Lewin’s Change Theory “theorized a three-stage model of change known as the unfreezing-change-refreeze model that requires prior learning to be rejected and replaced” (Petiprin, 2020). Drawing from the unfreezing stage, Lewin suggests that teams and people let go of old, counterproductive habits that no longer serve a purpose; in this case, a lack of policy or procedure around patient-provider communications.
NURS FPX 8010 Assessment 4 Quality Improvement Proposal
The change stage theorizes that those same people or teams need to process and work through the newly implemented changes, which may require leaders to take a more vested interest in their teams and their adjustment to a new version of productivity. Lastly, the refreezing stage is a method of solidifying the new change to make it habitual. For this project, the standard operating procedure and supporting policies would be finalized and disseminated across the organization and leaders would be expected to hold their teams accountable and prevent them from returning to old habits which diminish the patient experience.
Adelante’s strategic priorities are spread across four domains: finance, people, patients, and wellness. The selected nursing department priority for this quality improvement proposal is patient experience which aligns directly with Adelante’s patient satisfaction objective in the patient domain. In conducting a SWOT analysis (Avila, 2022), strengths, weaknesses, opportunities, and threats were reviewed and can be seen below.
SWOT Analysis
|
Strengths |
Weaknesses |
|---|---|
| The project team is comprised of individuals with extensive medical knowledge, background, and experience such as leadership, operations, quality, nursing, and clinical informatics. | There is no guarantee that clinical staff and providers will continue to adhere to modified guidelines and processes following project implementation. |
| The project will focus on the quality measures relevant to the organization through an improvement in key performance indicators (KPIs) such as patient satisfaction scores. | The timing of project planning and implementation competes with daily tasks and priorities of team members for this project. Setting aside dedicated project time may be a challenge. |
| Using an optimized provider inbox within the EMR will improve the quality of care provided to patients and enhance clinical staff satisfaction. | A lack of understanding of the root issue of the problem may require more resources initially than initially anticipated. |
| Increased patient satisfaction can promote increased patient referrals and visits to the clinics, which improves revenue generation for the organization. |
|
Opportunities |
Threats |
|---|---|
| Talent retention: improved patient-provider communications and have a beneficial impact on provider retention and satisfaction scores. | Staff turnover may increase and make implementation and training more challenging. |
| Provides more timely labs and diagnostic services and results to Adelante’s patients. | Clinical staff do not currently have a good understanding of the process or problem; gaining buy-in may be a challenge. |
| Improving patient retention through advocacy and resource provisioning via the inbox optimization. |
|
Risk Level |
Risk |
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