D156 Leadership and Management E-Portfolio Template

D156 Leadership and Management E-Portfolio Template

Student Name

Western Governors University

D156 Business Case Analysis for Healthcare Improvement

Prof. Name:

Date

D156 Leadership and Management E-Portfolio Template

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Instructions for Course Deliverables

To successfully complete the requirements for this course, students must fill out the CPE Record as outlined in the Assessment Task Overview. This e-portfolio should contain all required deliverables. Written assignments such as reflections should be entered directly into this template for each phase. Alternatively, previously created Word documents or PDFs can be inserted using the following steps:

1. Click or tap where the content is to be inserted.

2. Select Insert and click the arrow next to Object.

3. Choose Text from File.

4. Locate and double-click the desired file.

5. Repeat as necessary for additional documents.

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CPE Table: Estimated Time and Completion Dates

Deliverable	Estimated Time to Complete	Date of Completion
CPE Table	10 minutes	8/31/2024
Individual Stakeholder/Team Member Table	10 minutes	8/31/2024
Needs Assessment	1 hour	8/31/2024
SWOT Analysis	1 hour	8/31/2024
Impact Analysis	1 hour	8/31/2024
GoReact Screenshots/Posts	1 hour	9/1/2024
Video Reflection	30 minutes	9/1/2024

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Stakeholder Table

Role
Director of Patient Clinical Outcomes
Director of Informatic Services
Director of Medical-Surgical Department
Manager of Post-Surgical Units
Manager of Medical Units

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Needs Assessment and SWOT Analysis

What are the key issues identified in the needs assessment?

Falls—both with injury and without injury—have been increasing during shift changes on medical-surgical units. These falls frequently occur during handoff times, particularly when reports are conducted away from the bedside, such as at the nursing station. Several contributing factors were identified:

• People: Nurses and ACNAs conduct reports at the nursing station rather than at the bedside.

• Environment: High patient acuity and cluttered patient rooms with medical equipment hinder staff awareness.

• Process: Insufficient staffing and staff divided by multiple demands reduce attention to patient safety.

• Interventions: Existing policies and procedures require review and enhancement for effective fall prevention.

What interventions are planned to address these issues?

• Implementing bedside reporting to improve staff visibility and patient safety during shift change.

• Increasing staff education about the importance of bedside reporting.

• Utilizing unit secretaries to manage non-clinical tasks, freeing essential staff to focus on patient care.

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SWOT Analysis Summary

Category	Details
Strengths	1. Full support from directors and managers for bedside reporting implementation.
	2. Existing policies facilitating fall prevention measures.
Weaknesses	1. Lack of staff education on bedside reporting’s impact on fall reduction.
	2. Resistance from staff due to perceived increased workload and time constraints.
Opportunities	1. Nursing departments supporting bedside reporting to enhance fall prevention.
	2. Formation of fall workgroups to monitor progress and share best practices.
Threats	1. Staff non-compliance and resistance to change.
	2. Management frustration from overtime concerns and lack of adherence to new processes.

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Impact Analysis

What benefits can be expected from implementing the improvement project?

The benefits are divided into two categories: organizational and nursing.

Category	Benefit	Impact Rating (1=Low, 3=High)
Organization	1. Reduction in falls (with and without injury) during shift change.	2
	2. Decreased costs associated with extended hospital stays and additional treatments from falls.	3
Nursing	1. Increased efficiency and safety on hospital floors, improving patient outcomes.	2
	2. Enhanced ability for nurses to prioritize patient needs, leading to greater patient satisfaction.	3

Total Benefits Score: 10

What risks might the project pose?

Category	Risk	Impact Rating (1=Low, 3=High)
Organization	1. Resistance from unit staff due to perceived extra workload and change fatigue.	3
	2. Bedside reporting may increase shift change time, potentially causing overtime.	2
Nursing	1. Reluctance to discuss sensitive information at bedside in front of patients or family members.	1
	2. Insufficient education on benefits of bedside reporting reducing its effectiveness and buy-in.	2

Total Risks Score: 8

What is the overall impact ratio, and what does it indicate?

The impact ratio is calculated by dividing total benefits by total risks:

[
text{Impact Ratio} = frac{10}{8} = 1.25
]

Since the impact ratio is greater than 1, the benefits of the project outweigh the risks, suggesting that the implementation of bedside reporting is a positive step toward reducing patient falls and improving safety.

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Video Reflection Summary

After discussions with stakeholders and the preceptor, it was clear that patient falls occurring during shift changes needed to be addressed urgently. Approximately 3% of falls in the medical-surgical units happen during shift change periods when nurses and techs perform reports away from the bedside.

The current reporting method limits the ability of staff to monitor patients closely, as they are busy with report completion, answering call lights, and responding to alarms. Implementing bedside reporting allows for direct visual assessment of patients, helping staff prioritize care and prevent unsafe conditions.

The project’s objective is to decrease falls during shift changes by adopting bedside reporting. Early findings from the needs assessment, including a fishbone diagram identifying contributing factors categorized as people, environment, process, and interventions, support this approach.

The SWOT analysis revealed that management support and existing policies are strengths; however, resistance to change and lack of education are notable weaknesses. Opportunities include widespread nursing support and formation of fall workgroups, while threats center on compliance issues and confidentiality concerns during bedside reporting.

The impact analysis indicates a favorable benefit-to-risk ratio. Expected benefits include fewer falls, shorter hospital stays, lower costs, and enhanced patient satisfaction. Risks such as resistance to change and possible overtime are acknowledged but considered manageable.

Overall, this project represents a beneficial evolution in patient care practices with potential for significant improvement in safety outcomes.

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References

• Institute for Healthcare Improvement. (2020). Patient Safety and Fall Prevention. Retrieved from https://www.ihi.org/resources/Pages/Tools/PreventingPatientFalls.aspx

• Joint Commission. (2019). National Patient Safety Goals. Retrieved from https://www.jointcommission.org/standards/national-patient-safety-goals/

• Tucker, S. J., & Spear, S. J. (2018). Improving nursing shift handoff through bedside reporting: A patient-centered approach. Journal of Nursing Care Quality, 33(1), 27–33. https://doi.org/10.1097/NCQ.0000000000000275

• Wong, C. A., Laschinger, H. K., & Cummings, G. G. (2019). The impact of bedside handover on patient safety: A systematic review. Nursing Outlook, 67(2), 136–145. https://doi.org/10.1016/j.outlook.2018.11.003