This paper is based off my clinical rotation with a hospital administrator. For this project we were suppose to find a hospital issue that proposes challenges for nurses. We are suppose to recognize that challenge and find out why it exists, create a solution to the problem and implement it and then follow up to trace improvement. The topic i have chosen to focus on for this project is the New York State Care Act. This Act was implemented by law in April this year. The law is to help patients appoint a trusted individual in their life to be involved in their discharge process. That individual will be involved in discharge teaching along with the patient just in case there are any gaps in communication with the patient and the provider also the patient may forget instructions given, so they are an extra ear. Every hospital in New York is required to implement this initiative by law. In Winthrop hospital (the hospital i do my rotation in) This act is filled out with the nurse and the patient at the time of admission. Every patient over 18 is required by law to have this form. I audited compliance of this form. During the audit of 4 random units in the hospital, I realized nurses were 33% compliant. when asking staff why this is a challenge for them I received responses such as: \”we do not get the forms in the admission packet\”, \”we heard about the forms but never see them\” \”we do not know where to print it\” \”we are not use to this additional form so we forget\” \”We don\’t know where to keep it in the chart\”. After the audit we re-educated staff/nurses on the importance of of this form. when we re-educated the nurses by reinforcing that it was important because the form will help patients become more integrated with their care, it reduces readmission bc it allows patients to reduce complications at home, it increases patient satisfaction, and increases quality outcomes. we suggested that this for be placed in the front of the patients chart, we did this to develop consistency of where it will be located. We also contacted the registration office, where all admission packets are located and had them make sure that all New York Care Act forms would now be printed with all admission packets so that no one has to print them separately on the units. That way nurses can consistently have the for available to sign when the patients are signing their admission documents. After implementing those 2 steps we went to the units and audited charts again and saw a 90% compliance. Therefore the re-education, the initiation of placing them in admission packets, and finding a permanent place for these forms has increased compliance and improved this challenge. This paper needs to incorporate/reflect on what i experienced (as is wrote above, can be reworded nicer) and needs to incorporate what the Care Act is, why it was initiated by law (the background), the benefits the law presents to the patient, the benefits it presents to the hospital( ex: deceases readmission which saves hospitals money, saves hospital cost, etc) There needs to be a literature review section. I need 2 literature reviews, maybe on remissions, or patient incorporating a trust on in their care ( I am sure there are benefits) etc. Paper: 1. Intro: What is the New York State Care Act? What is the importance/benefit 2. Literature review: is this happening anywhere else? (anything that links nicely) 3. must have a Change theory ( the paper needs the be linked to a change theory, a nursing change theory, can be googled) 4. How the Act was implemented within the institution( nurses were educated on this initiative, unit managers spoke to the staff during meetings to remind them, emails were sent out to nurses) 5. Identify the challenges within the institution after Act was initiated( nurses found it difficult to adapt to for bc they were not use to it, they could not find it in admission packet, unit secretaries did not know where to print them, managers were not CONSISTENTLY speaking to the importance of document) 6. Identify your role in fixing the challenge ( I audited 4 units to get a baseline of where nurses stood with compliance, reeducated them, came up with ideas to incorporate document in admission pack, found a permanent place in the chart for them etc) 7.How was my plan effective. 8. conclusion this is instructions from the syllabus: Administration in Action Analysis Paper: 25% Students will critically analyze a health services management challenge presenting at their assigned clinical site. Your objective here is to critically analyze the situation and integrate the complex issues presented in the case. Analyses should use course concepts and readings to suggest solutions to the problems presented in the health services organization. Paper must be 4 pages in length. APA citation format and graduate level submission is required. Points will be deducted for pages above maximum length.
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