This week, my preceptor and I had a one on one evaluation discussion session. It was sort of similar to my mid- semester self evaluation. The slight difference is that I had to select just three areas from the list of competencies and summarize my experiences.
We started off evaluating how this whole learning experience has helped improve in areas of leadership, interpersonal, and fiscal competencies. In the process, I had to relate these competencies giving examples on way to apply to professional development. Below is a summary of the my feedback
Leadership Competencies
As an effective leader
1. I would identify a vision and empower team members to achieve the vision. At the same time, emphasizing that the patients needs is the basis (priority) for health services.
2. Improve my ability to balance attention to people and to task- time is always a critical factor and as such, effective time management skill is necessary for successful leadership.
3. Additionally as part of effective time management, I would delegate task to employees that are capable of effectively performing the task. J.C acknowledged that group efficiency increases when task are assigned to the first level in the hierarchy where employees poses the necessary skills and knowledge to complete the task. In the process of delegation, I share responsibility and maintain final accountability for the safe, effective outcome of the task
4. Improve in my ability to make decision effectively. I have learnt that there are situations, when a leader must take a more participatory decision making/planning style to promote acceptance (for example my change project). One the other hand, there are instance where participatory decision making can be time consuming and as a result a unilateral, independent decision style is necessary.
Interpersonal Competencies
I n the course of improving my communication skills, I have learnt that it is especially critical to listen carefully, make underlying assumptions clear, avoid the use of professional jargons and to be culturally sensitive. Additionally as a good leader, I would apply initiatives (employee recognition, special bonuses for achievement, flexibility in scheduling and opportunity for staff development) that promote a motivating work place and employee satisfaction.
Fiscal Competencies
In the area of fiscal management, I have learnt how to develop a justifiable budget and monitor how actual spending compares with planned spending. I explained that as an effective leader, it is helpful to obtain staff input when developing a budget in order to make financial projections as realistic as possible. I have learnt how to analyze a variance report of a budget, determining the cause of the variation and how to use this to work on future budget to provide cost effective care.
In the end I believe the whole learning experience has improved my competency in nursing leadership and management skills to achieve organizational and professional goals for patient services and clinical outcomes.
Total clinical hour- 10hours
Tuesday, November 17, 2009
Thursday, October 29, 2009
Mid-semester Self- Review and Analysis
2 course clinical objectives
Leadership skills
Learning from my preceptor (J.C) has in so many ways helped me improve my leadership skills. My preceptor is engaged in a range of leadership activities in her daily routine. I was opportune to attend a staff development meeting which addressed different issues that affects effective leadership in the work environment. During this process, I have gained a better understanding of how effective leadership, positive attitudes, successful collaboration and efficient communication all work hand in hand and am critical in delivering high-quality care, ensuring patient safety and facilitating positive staff development. Providing patient’s care requires a collaborative effort, which involves effective team building. I have learnt it is the responsibility of a good leader to build these effective teams, by providing guidance, coordinating the activities of team members, providing resources to deliver positive patient care.
Client advocate
As nurses, patient advocacy is an important competent of our professional identity. By attending the last QA/CQI meeting, I had the opportunity to be more assertive in leadership as I collaborated with other healthcare providers, by using knowledge to produce thoughtful and resourceful insight to advocate for safe and effective quality care for patients.
2 Personal clinical objectives
One of my primary personal objectives was to learn leadership skills that deal with clinical issues such as planning, budgeting and setting target goal. However, on my second clinical day, I was able to address this objective. I learnt how to utilize a particular budgeting style (formula/program budget) to provide cost effective care .Additionally, it highlighted how planning, setting goals and allocation of resources are typically tied to the proposed budget. However, been the facility administrator, my preceptor is responsible for ensuring that compliance and audit requirement are met, so as to achieve productivity ration and budget target. In this process, I have learnt that for clinical outcomes to be good and to stay within or slightly deviate from the proposed budget, team members must adhere to policy and set guidelines when providing care.
My other objective was focused on learning how to incorporate effective time management to achieve personal and professional goals. My preceptor explained to me, the different time management techniques (planning, setting goals, prioritizing, eliminating procrastination and time stealer, delegating etc) that can be utilizes to help promote productivity and reduce stress. From this experience, I have made it a practice habit to always start off each day with outlined goals and task (to- do list). Additionally, I have learnt that by applying the Pareto’s principle (80/20 rule) when prioritizing task, I could be more efficient in time management.
Overall review of personal objectives
So far from my clinical experience, I believe I have been able to address all of my personal objectives. From the staff development meeting, I have learnt effective leadership styles (such as mentoring, promoting positive attitudes, and good communication) that can facilitate group collaboration and positive patient outcomes. In the same process, I have learnt how mentorship and professional socialization can influence and create the environment in which nursing can flourish.
How this has fostered my professional growth
This whole learning experience has helped me professionally gain more confidence and competency when addressing healthcare issues. I have learnt to be more accountable for my professional growth, by seeking out professional opportunities, expanding my knowledge base, supporting professional certification and technological advancement (my change project) as well as influencing and inspiring others to achieve higher levels of responsibility.
Leadership skills
Learning from my preceptor (J.C) has in so many ways helped me improve my leadership skills. My preceptor is engaged in a range of leadership activities in her daily routine. I was opportune to attend a staff development meeting which addressed different issues that affects effective leadership in the work environment. During this process, I have gained a better understanding of how effective leadership, positive attitudes, successful collaboration and efficient communication all work hand in hand and am critical in delivering high-quality care, ensuring patient safety and facilitating positive staff development. Providing patient’s care requires a collaborative effort, which involves effective team building. I have learnt it is the responsibility of a good leader to build these effective teams, by providing guidance, coordinating the activities of team members, providing resources to deliver positive patient care.
Client advocate
As nurses, patient advocacy is an important competent of our professional identity. By attending the last QA/CQI meeting, I had the opportunity to be more assertive in leadership as I collaborated with other healthcare providers, by using knowledge to produce thoughtful and resourceful insight to advocate for safe and effective quality care for patients.
2 Personal clinical objectives
One of my primary personal objectives was to learn leadership skills that deal with clinical issues such as planning, budgeting and setting target goal. However, on my second clinical day, I was able to address this objective. I learnt how to utilize a particular budgeting style (formula/program budget) to provide cost effective care .Additionally, it highlighted how planning, setting goals and allocation of resources are typically tied to the proposed budget. However, been the facility administrator, my preceptor is responsible for ensuring that compliance and audit requirement are met, so as to achieve productivity ration and budget target. In this process, I have learnt that for clinical outcomes to be good and to stay within or slightly deviate from the proposed budget, team members must adhere to policy and set guidelines when providing care.
My other objective was focused on learning how to incorporate effective time management to achieve personal and professional goals. My preceptor explained to me, the different time management techniques (planning, setting goals, prioritizing, eliminating procrastination and time stealer, delegating etc) that can be utilizes to help promote productivity and reduce stress. From this experience, I have made it a practice habit to always start off each day with outlined goals and task (to- do list). Additionally, I have learnt that by applying the Pareto’s principle (80/20 rule) when prioritizing task, I could be more efficient in time management.
Overall review of personal objectives
So far from my clinical experience, I believe I have been able to address all of my personal objectives. From the staff development meeting, I have learnt effective leadership styles (such as mentoring, promoting positive attitudes, and good communication) that can facilitate group collaboration and positive patient outcomes. In the same process, I have learnt how mentorship and professional socialization can influence and create the environment in which nursing can flourish.
How this has fostered my professional growth
This whole learning experience has helped me professionally gain more confidence and competency when addressing healthcare issues. I have learnt to be more accountable for my professional growth, by seeking out professional opportunities, expanding my knowledge base, supporting professional certification and technological advancement (my change project) as well as influencing and inspiring others to achieve higher levels of responsibility.
Wednesday, October 28, 2009
Journal 6- QA/CQI Part 2
Tuesday, 27th 2009
QA/CQI meeting started off today at 10am with a pretty descent size attendance. At the meeting was the medical director, my preceptor and I, the clinical coordinator, QA/CQI coordinator, anemia manager, biomedical technician, vascular access coordinator, dietician, social worker, safety/ hazardous communication director, reuse technician, infection control coordinator, training/in-service coordinator, facility maintenance manager, peritoneal and home-hemodialysis coordinator. At the start of the meeting I was introduced to all team members by my preceptor. She clearly stated the role I would be playing in the review process. I was quite surprise at their warmth and receptive welcome address. However, I must admit I was a bit anxious of what was expected of me. Nevertheless, with all the information I had reviewed, I felt somewhat prepared.
The QA/CQI coordinator was the primary moderator for the meeting. She started off by reviewing the specific accountability tool on the QA report. Each member of the QA/CQI team has an individual tool that is specific to their area of accountability. For example, nutrition and bone management (phosphorus, calcium, PTH levels etc) are primarily managed by the dietician. During the meeting, as we reviewed the overall and individual patient data on bone management from the previous month, I observed a consistent trends of data falling out of range as specified by the clinical guidelines(60% of the patient were having problems with elevated phosphorus). In this process, the dietician explained why goals were not met and the same time she drafted out a plan on how to improve outcomes. One of her suggestions was for these patients to switch to a different phosphate binder (from RenaGel to Renvela). According to the dietician, evidence based reports clearly shows that Renvela is very effective in maintaining phosphorus and calcium level within therapeutic range , however the issue of cost( Renvela is one of the most expensive orally- prepared phosphate binders in the market) is something that might deter most patient from compliance. Therefore to improve compliance, the social worker suggested that these patients could apply for prescription assistance to the End Stage Renal Disease Network (ESRD).
As the meeting progressed, we reviewed other areas like patient mortality, safety programs review, blood pressure and anemia management, infection control, patient satisfaction and adherences to treatment. Etc. At that point, working closely with the infection control and vascular access coordinator, I was required to discuss some of the current issues with infection control. From the previous QA/CQI reports and the data’s from the current month, I observed that although infection reporting incidents were on the decrease, actual goals were still not met. One of the primary reasons for this was the problem of vascular access (Arterial-Venous shunts) and central venous catheter infections. Based on reviewed literature and the facility policy, I observed that the facility’s current clinical guidelines on accessing the different types of vascular access were not only supposedly efficient but also evidence based. Considering that, I was concern if the teammates were properly implementing these clinical guidelines in their practice. My suggestions was for the clinical educator to review to all direct care providers(nurses and patient care technicians) ,the facility’s policy and procedure on how to properly handle the different types of vascular access and the outcomes would be reevaluated in the next QA meeting.
On the issue of patient satisfaction and adherence, I observed that one of the primary reasons for lack of adherence and missed treatment was due to the time of treatment hours. The clinic operation hours are from 5am to 6pm, as a result majority of the working patient expressed dissatisfaction with this hours. My suggestion was for the facility to consider extending clinic hours (maybe to 9pm) to try to accommodate working patient and others that fall in this categories and the outcome would be evaluated in the next meeting.
At the end of this review, this was a wonderful learning experience for me. I learnt that the proper implementation of a QA/CQI program is a way that I can advocate for patients’ by collaborating with other members of the interdisciplinary team to ensure care provided is safe and effective and results in patient satisfaction. My preceptor was very impressed with the way I professionally addressed these issues to help promote positive patient outcomes. She thanked me for my resourceful contributions.
Clinical hours- 6
QA/CQI meeting started off today at 10am with a pretty descent size attendance. At the meeting was the medical director, my preceptor and I, the clinical coordinator, QA/CQI coordinator, anemia manager, biomedical technician, vascular access coordinator, dietician, social worker, safety/ hazardous communication director, reuse technician, infection control coordinator, training/in-service coordinator, facility maintenance manager, peritoneal and home-hemodialysis coordinator. At the start of the meeting I was introduced to all team members by my preceptor. She clearly stated the role I would be playing in the review process. I was quite surprise at their warmth and receptive welcome address. However, I must admit I was a bit anxious of what was expected of me. Nevertheless, with all the information I had reviewed, I felt somewhat prepared.
The QA/CQI coordinator was the primary moderator for the meeting. She started off by reviewing the specific accountability tool on the QA report. Each member of the QA/CQI team has an individual tool that is specific to their area of accountability. For example, nutrition and bone management (phosphorus, calcium, PTH levels etc) are primarily managed by the dietician. During the meeting, as we reviewed the overall and individual patient data on bone management from the previous month, I observed a consistent trends of data falling out of range as specified by the clinical guidelines(60% of the patient were having problems with elevated phosphorus). In this process, the dietician explained why goals were not met and the same time she drafted out a plan on how to improve outcomes. One of her suggestions was for these patients to switch to a different phosphate binder (from RenaGel to Renvela). According to the dietician, evidence based reports clearly shows that Renvela is very effective in maintaining phosphorus and calcium level within therapeutic range , however the issue of cost( Renvela is one of the most expensive orally- prepared phosphate binders in the market) is something that might deter most patient from compliance. Therefore to improve compliance, the social worker suggested that these patients could apply for prescription assistance to the End Stage Renal Disease Network (ESRD).
As the meeting progressed, we reviewed other areas like patient mortality, safety programs review, blood pressure and anemia management, infection control, patient satisfaction and adherences to treatment. Etc. At that point, working closely with the infection control and vascular access coordinator, I was required to discuss some of the current issues with infection control. From the previous QA/CQI reports and the data’s from the current month, I observed that although infection reporting incidents were on the decrease, actual goals were still not met. One of the primary reasons for this was the problem of vascular access (Arterial-Venous shunts) and central venous catheter infections. Based on reviewed literature and the facility policy, I observed that the facility’s current clinical guidelines on accessing the different types of vascular access were not only supposedly efficient but also evidence based. Considering that, I was concern if the teammates were properly implementing these clinical guidelines in their practice. My suggestions was for the clinical educator to review to all direct care providers(nurses and patient care technicians) ,the facility’s policy and procedure on how to properly handle the different types of vascular access and the outcomes would be reevaluated in the next QA meeting.
On the issue of patient satisfaction and adherence, I observed that one of the primary reasons for lack of adherence and missed treatment was due to the time of treatment hours. The clinic operation hours are from 5am to 6pm, as a result majority of the working patient expressed dissatisfaction with this hours. My suggestion was for the facility to consider extending clinic hours (maybe to 9pm) to try to accommodate working patient and others that fall in this categories and the outcome would be evaluated in the next meeting.
At the end of this review, this was a wonderful learning experience for me. I learnt that the proper implementation of a QA/CQI program is a way that I can advocate for patients’ by collaborating with other members of the interdisciplinary team to ensure care provided is safe and effective and results in patient satisfaction. My preceptor was very impressed with the way I professionally addressed these issues to help promote positive patient outcomes. She thanked me for my resourceful contributions.
Clinical hours- 6
Friday, October 23, 2009
Journal 5- QA/CQI Review Part 1
Tuesday, 20th 2009
Monthly QA/CQI review at my clinical site is scheduled for next week and it appears I would not only be attending but also contributing. However, prior to this meeting, my preceptor (J.C) and I have decided that I would review previous QA/CQI reports and in the process, she would explain the different areas/items on this monitory tool. We started off with her explaining what the QA/CQI monitory tool was and it’s benefits. According to J.C, the QA/CQI reviews is a way in which each member of the interdisciplinary team come together to review and indentify areas of clinical practice and the environment that requires improvement or change in the processes, policies and procedures. The QA/CQI monitoring tool, analyzes a wide range of issues that affect patient care. As stated by J.C, a few examples includes, growth and capacity of the facility, patient mortality, patient satisfaction, clinical standards and outcome goal (patient treatment adherence, anemia, nutrition, bone diseases and blood pressure management), hospitalization trends, infection control, etc. When examining the report, previous goal are evaluated as new goals are set and implementations are either continued (if effective) or revised (not effective) and eventually leading to process improvement.
We both agreed that by attending this review, I could use this opportunity to transit my learning experience from an observatory role to a more participatory role. After reviewing the previous month report, I picked two areas of interest (clinical standards and outcomes goal (patient treatment adherence) and infection control), that I would be offering health promotion/maintenance initiatives inputs to help facilitate positive clinical outcomes for the next month. Based on my preceptor’s recommendation, I reviewed a couple of evidence based researched literatures related to these areas. In the process, I was able to identify specific causes of non-compliance to treatment, major infection control issues, and ways to improve adherence to treatment regimen and infection among dialysis patient. Additionally, she provided feedback; guidance and clarification to help me better understand QA/CQI as it relates to safety and quality of patient’s care.
In the end, I must admit that this pre introductory QA/CQI review was a good head start. I am extremely excited and looking forward to next week’s meeting. This would be the opportunity I have been waiting for, where I can actually but to effective use some of the leadership skills learnt, by utilizing my knowledge, competencies and skills to help patient achieve the highest level of quality care, health and well being.
From this learning experience, I learnt that QA/CQI reviews are vital monitoring tools, that if properly implemented would promote positive patient outcome.
Clinical Hour- 6hours
Monthly QA/CQI review at my clinical site is scheduled for next week and it appears I would not only be attending but also contributing. However, prior to this meeting, my preceptor (J.C) and I have decided that I would review previous QA/CQI reports and in the process, she would explain the different areas/items on this monitory tool. We started off with her explaining what the QA/CQI monitory tool was and it’s benefits. According to J.C, the QA/CQI reviews is a way in which each member of the interdisciplinary team come together to review and indentify areas of clinical practice and the environment that requires improvement or change in the processes, policies and procedures. The QA/CQI monitoring tool, analyzes a wide range of issues that affect patient care. As stated by J.C, a few examples includes, growth and capacity of the facility, patient mortality, patient satisfaction, clinical standards and outcome goal (patient treatment adherence, anemia, nutrition, bone diseases and blood pressure management), hospitalization trends, infection control, etc. When examining the report, previous goal are evaluated as new goals are set and implementations are either continued (if effective) or revised (not effective) and eventually leading to process improvement.
We both agreed that by attending this review, I could use this opportunity to transit my learning experience from an observatory role to a more participatory role. After reviewing the previous month report, I picked two areas of interest (clinical standards and outcomes goal (patient treatment adherence) and infection control), that I would be offering health promotion/maintenance initiatives inputs to help facilitate positive clinical outcomes for the next month. Based on my preceptor’s recommendation, I reviewed a couple of evidence based researched literatures related to these areas. In the process, I was able to identify specific causes of non-compliance to treatment, major infection control issues, and ways to improve adherence to treatment regimen and infection among dialysis patient. Additionally, she provided feedback; guidance and clarification to help me better understand QA/CQI as it relates to safety and quality of patient’s care.
In the end, I must admit that this pre introductory QA/CQI review was a good head start. I am extremely excited and looking forward to next week’s meeting. This would be the opportunity I have been waiting for, where I can actually but to effective use some of the leadership skills learnt, by utilizing my knowledge, competencies and skills to help patient achieve the highest level of quality care, health and well being.
From this learning experience, I learnt that QA/CQI reviews are vital monitoring tools, that if properly implemented would promote positive patient outcome.
Clinical Hour- 6hours
Sunday, October 18, 2009
Journal Entry 4- Time Management a vital tool for professional development
This week’s clinical experience was mainly focused on exploring different ways on how to be more proficient in time management. Since this is an area I have struggled with in the past, I was very excited to learn from my preceptor the different techniques that she has utilized and how this has helped her achieve personal and professional goals. As clearly stated by Julie, to be an efficient leader, it is important to understand that they is a close relationship between time and stress management. When time is put to efficient use, stress is reduced and productivity is increased. She explained that as a result of her ability to effectively manage her time, she is able to multi-task/joggle the demands and responsibilities of been the facility administrator. .
To start of her day, my preceptor like most nurses plans and schedules activities in other to accomplish set goals. She has a year-planner, which depicts the major responsibilities for the coming year. It shows at a glance when the budget must be completed, when monthly staff meeting are to take place, when meriting sessions are to be attended, annual interdisciplinary teams reviews, etc. In addition to that, she keeps a monthly, weekly and daily calendar/planner which streamlines all activities to achieve major goals. A sample of her daily planner, reflects scheduled meetings (with block in times) an on-going to do list, that is flexible and allows sufficient time for unexpected emergencies and crises that may occur. Alongside her to do list, she prioritizes each daily activity first by importance and urgency second. She explained how she uses the 80/20 rule to assign importance to each task. From this principle, I learnt that 80% of the positive, satisfactory outcomes we get are as a result of 20% of time spent, so therefore it is important to pay particular attention to the very important tasks and not get involved in all the trivial projects that crops up within the day.
During the course of the day, I noticed that Julie set aside some specific task aside for the clinical managers to oversee. She explained that she tends to delegate minor task in other to give her more time to attend to organizational function and meetings. I also observed that her visiting time was strictly by appointment only, except when an urgent patient request arises . While rounding with the clinical supervisor, the meeting was very brief and straight to the point. I addition she sets aside her private time for personal reflection and relaxation.
From the learning experience, I can now understand, why Julie, despite her numerous daily responsibilities, she is still able to maintain productively and be stress free. I have learnt that, in other to be more proficient in my time management, I would need to adopt effective strategies such as planning/setting goals, eliminating time stealers such as procrastination and perfectionism.
6 clinical hours
To start of her day, my preceptor like most nurses plans and schedules activities in other to accomplish set goals. She has a year-planner, which depicts the major responsibilities for the coming year. It shows at a glance when the budget must be completed, when monthly staff meeting are to take place, when meriting sessions are to be attended, annual interdisciplinary teams reviews, etc. In addition to that, she keeps a monthly, weekly and daily calendar/planner which streamlines all activities to achieve major goals. A sample of her daily planner, reflects scheduled meetings (with block in times) an on-going to do list, that is flexible and allows sufficient time for unexpected emergencies and crises that may occur. Alongside her to do list, she prioritizes each daily activity first by importance and urgency second. She explained how she uses the 80/20 rule to assign importance to each task. From this principle, I learnt that 80% of the positive, satisfactory outcomes we get are as a result of 20% of time spent, so therefore it is important to pay particular attention to the very important tasks and not get involved in all the trivial projects that crops up within the day.
During the course of the day, I noticed that Julie set aside some specific task aside for the clinical managers to oversee. She explained that she tends to delegate minor task in other to give her more time to attend to organizational function and meetings. I also observed that her visiting time was strictly by appointment only, except when an urgent patient request arises . While rounding with the clinical supervisor, the meeting was very brief and straight to the point. I addition she sets aside her private time for personal reflection and relaxation.
From the learning experience, I can now understand, why Julie, despite her numerous daily responsibilities, she is still able to maintain productively and be stress free. I have learnt that, in other to be more proficient in my time management, I would need to adopt effective strategies such as planning/setting goals, eliminating time stealers such as procrastination and perfectionism.
6 clinical hours
Wednesday, October 7, 2009
Journal Entry 3
10/6/09
Journal 3
This week’s learning experience was quite different from the previous week, in the sense that it was more of an educational/information led session. I was opportune to attend a staff development meeting and one of the pressing issues discussed, addressed one of my objectives (i.e. how mentorship and professional socialization can influence and create the environment in which professional nursing can flourish). The prime goal of the staff development meeting was centered on team building. According to Julie, there have been recent complaints from clinical supervisors and other staff members on lack of teamwork, conflict/tension noted between clinical supervisors and other staff members, increasing trends in employee abstinence, non compliance with facility’s policies and procedures. She stated that within the last two months, she had to fire two employees due to work related conflict that resulted to violence. In other to address these problems, she had to consult with the central office for a clinical educator to in-services employees on staff development.
The meeting started off exploring 4 key characteristics of quality teams: effective leadership, positive attitudes, successful collaborations and efficient communication. The emphasis was for each member to adopt the last three characteristic in their individual practice to promote a cohesive team that offers mutual support for each member. The importance of effective leadership was primarily directed to the clinical supervisors and managers. As explained by the clinical educator, it is important for an effective leader to seek out a positive environment that will encourage all staff members to learn and contribute. However, such an environment would foster cohesion, collaboration and would ultimately lead to an excellent team. She showed illustrations on how positive attitudes builds on teamwork and also that mutual trust among staff members are critical to successful team processes. Additionally, she explained that mentoring is a responsibility that is crucial to effective leadership. A clinical supervisor/manger that fosters a positive attitude in employees will allow development of the capacity to work together as a team and overcome obstacles. With a positive attitude, staff members would become comfortable in addressing issues among themselves, problem solving together and resolving conflicts.
From the whole experience, I learnt that as a practice management issues’, building a successful team is essential for staff development within a clinic setting. Additionally, a positive work environment, would increase employee satisfaction and reduce turn over as well as improve quality of care, patient satisfaction and patient outcomes.
Total clincal hours- 6hours
Journal 3
This week’s learning experience was quite different from the previous week, in the sense that it was more of an educational/information led session. I was opportune to attend a staff development meeting and one of the pressing issues discussed, addressed one of my objectives (i.e. how mentorship and professional socialization can influence and create the environment in which professional nursing can flourish). The prime goal of the staff development meeting was centered on team building. According to Julie, there have been recent complaints from clinical supervisors and other staff members on lack of teamwork, conflict/tension noted between clinical supervisors and other staff members, increasing trends in employee abstinence, non compliance with facility’s policies and procedures. She stated that within the last two months, she had to fire two employees due to work related conflict that resulted to violence. In other to address these problems, she had to consult with the central office for a clinical educator to in-services employees on staff development.
The meeting started off exploring 4 key characteristics of quality teams: effective leadership, positive attitudes, successful collaborations and efficient communication. The emphasis was for each member to adopt the last three characteristic in their individual practice to promote a cohesive team that offers mutual support for each member. The importance of effective leadership was primarily directed to the clinical supervisors and managers. As explained by the clinical educator, it is important for an effective leader to seek out a positive environment that will encourage all staff members to learn and contribute. However, such an environment would foster cohesion, collaboration and would ultimately lead to an excellent team. She showed illustrations on how positive attitudes builds on teamwork and also that mutual trust among staff members are critical to successful team processes. Additionally, she explained that mentoring is a responsibility that is crucial to effective leadership. A clinical supervisor/manger that fosters a positive attitude in employees will allow development of the capacity to work together as a team and overcome obstacles. With a positive attitude, staff members would become comfortable in addressing issues among themselves, problem solving together and resolving conflicts.
From the whole experience, I learnt that as a practice management issues’, building a successful team is essential for staff development within a clinic setting. Additionally, a positive work environment, would increase employee satisfaction and reduce turn over as well as improve quality of care, patient satisfaction and patient outcomes.
Total clincal hours- 6hours
Thursday, October 1, 2009
Journal Entry 2
9/29/09
My objective for today is to learn how to effectively utilize human and material resources strategies, types of budgeting techniques used to provide cost-effective quality care. In order to achieve this, we started off doing the previous month financial review and auditing the budget analysis (treatment audit VS resources audit), drafting a sample facility budget for the next month. Julie explained that since the facility is subdivided into 3 independent unit (in center hemodialysis unit, home hemodialysis training clinic and peritoneal dialysis unit), she tend to utilizes a combination of two types of budgeting techniques (formula/ program budget).
I reviewed the past three month budget analysis and in the process, she explained how to draft a sample budget. In addition to the month to month budget, she has to do an annual budget proposal for the next year, usually in the month of November. From this sample budget draft, I learnt that allocations of resources (such salary paid to employee, project quantity of supply usage) are typically tied to the numbers of treatment/services provided to patients. Julie explained that in order to stay within the proposed budget, one technique she uses is mandating that all clinical supervisors stay on top of patient to staff ratio. This involves a continuous reassessment of patient assignment and redistribution of workload within each shift. The clinical supervisors have to ensure that resources are not wasted. According to Julie, if all teammates adhere to policy and set guidelines when providing care, resources would be effectively utilized and clinical outcome would be good.
After reviewing the past 3 month budget analysis, I observed that there was only a slight variance from the actual budget to the expected budget. She explained that looking at the current budget trend; their facility has been meeting their goals, as compared with the other clinic within the region, state and nationwide. This learning experiences, highlighted a budgeting style that can be use to provide cost effective quality care, when utilizing set clinical guidelines. I have learnt that it is vital to have an understanding of good financial management in order to be successful in running a facility.
My objective for today is to learn how to effectively utilize human and material resources strategies, types of budgeting techniques used to provide cost-effective quality care. In order to achieve this, we started off doing the previous month financial review and auditing the budget analysis (treatment audit VS resources audit), drafting a sample facility budget for the next month. Julie explained that since the facility is subdivided into 3 independent unit (in center hemodialysis unit, home hemodialysis training clinic and peritoneal dialysis unit), she tend to utilizes a combination of two types of budgeting techniques (formula/ program budget).
I reviewed the past three month budget analysis and in the process, she explained how to draft a sample budget. In addition to the month to month budget, she has to do an annual budget proposal for the next year, usually in the month of November. From this sample budget draft, I learnt that allocations of resources (such salary paid to employee, project quantity of supply usage) are typically tied to the numbers of treatment/services provided to patients. Julie explained that in order to stay within the proposed budget, one technique she uses is mandating that all clinical supervisors stay on top of patient to staff ratio. This involves a continuous reassessment of patient assignment and redistribution of workload within each shift. The clinical supervisors have to ensure that resources are not wasted. According to Julie, if all teammates adhere to policy and set guidelines when providing care, resources would be effectively utilized and clinical outcome would be good.
After reviewing the past 3 month budget analysis, I observed that there was only a slight variance from the actual budget to the expected budget. She explained that looking at the current budget trend; their facility has been meeting their goals, as compared with the other clinic within the region, state and nationwide. This learning experiences, highlighted a budgeting style that can be use to provide cost effective quality care, when utilizing set clinical guidelines. I have learnt that it is vital to have an understanding of good financial management in order to be successful in running a facility.
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