Comment 1

Knowing scientific management theory as defined as supervising by way of focusing on task accomplishments rather than interpersonal relationships (Huber 2014). Some routines in health care that seem to be inefficient in regards to scientific management are the overwhelming focus on tasks, the evaluations based on tasks accomplished, and the pressure to join committees to add more tasks to nurses’ duties. A lot of times nurses have trouble tending to the needs of their patients because they are so focused on getting the tasks done so as to not get in trouble. Many times tasks are added to the nurses’ workload making it hard to complete everything on time. This causes incidental overtime which is also greatly frowned upon. Finally, the committees are supposed to be a good thing, allowing nurses to participate in shared governance. The issue arises when the requirements for the committees capitalize on the time the nurse should be working or decompressing from the stress of daily work. Some examples of participative decision-making at the hospital that I work at are unit forums and shared governance council. The unit forums allow for nurses and aides in the unit to meet and discuss issues to resolve amongst themselves. Shared governance councils allow for nurses to meet with administration to discuss issues at the bedside that can only be fixed by administration.

Comment 2

The scientific management theory states that humans are motivated by money, and there should be a separation between managers and workers. The expected result is a dramatic increase in productivity of the workers and profits for the organization. Some of the routines in the health care setting that are inefficient is nurse-to-patient ratio and staff retention. I feel the nurse-to-patient ratios are unsafe as it overloads the nurse and nursing assistants in carrying for high acuity patients with a higher prevalence of medical errors and oversight. When staffing is is done according to census instead of census it creates an unsafe environment for the patients and the staff. Without adequate staffing, patient care is inadequate and the patients suffer. Which in turns causes patient surveys to report negative feedback giving the hospital low numbers.Staff retention is important to ensure there is adequate staff to meet the demands of an aging population with numerous chronic illnesses. When facilities ignore the concerns of staff or do not provide attempt to implement change that benefits the staff and the patients, morale falls and staff leave. When nurses feel their safety and license are in jeopardy, they will seek out a better work environment they feel safe in. The facility I work for currently does annual retention surveys that allow its employees to voice any concerns and share what they feel the facility is doing well or could improve on. The nurses are asked various questions in regards to the leaders and managers they work directly under and whether their needs are being addressed. The facility offers committees that focus on allowing staff to have voice. Some include unit base council for each unit of the facility, committee for staffing concerns and safety committees that focus on sentinel events. 

Project 2: Promoting Health Care Quality

Section 4: Quality Improvement Strategies

Throughout this course you have been considering the relationship between structure, process, and outcomes as it relates to health care quality. Looking at outcomes, alone, may not tell the “whole story.” For instance, if you are concerned with improving fall rates, evaluating the process—related activities or practices—can help you identify factors that contribute to outcomes and develop strategies for improving them.

For this section of your Course Project, you create a process map to examine a current process related to your quality improvement issue. You will use the results of the process mapping to redesign a process to help minimize or close the performance gap(s). As you proceed, keep in mind the importance of maintaining a patient-centered focus so the patient experience is not negatively affected by any changes in process.

To prepare:

• Review the instructions provided in the Learning Resources for creating a process map.
• With your quality improvement issue in mind, as well as the other work you have completed on your Course Project thus far, think about how creating a process map could help you to better understand your quality improvement issue and redesign an associated process.
• Create a process map using Microsoft Word or PowerPoint.
• Refine the strategies for promoting systems-level change to minimize or close the performance gap(s) that you began to think about in Week 7. As part of this, identify a way to redesign at least one process based on your analysis of the process map that you have created.

To complete:

• Write a 2- to 3-page paper in which you describe quality improvement strategies that you selected related to your quality improvement issue.
• Finalize your process map, which will be submitted along with the paper.

Required Readings

Cookson, D., Read, C., Mukherjee, P., & Cooke, M. (2011). Improving the quality of emergency department care by removing waste using Lean Value Stream mapping. International Journal of Clinical Leadership, 17(1), 25–30.
Retrieved from the Walden Library databases.

This article demonstrates how a process map can be used to identify waste and promote efficiency, particularly in large departments.

Ford, J. H., Wise, M., & Wisdom, J. P. (2010). A peek inside the box: How information flows through substance abuse treatment agencies. Journal of Technology in Human Services, 28(3), 121–143.
Retrieved from the Walden Library databases.

The authors of this article establish the importance of using process maps for improving productivity and information flow.

Abubakker, H. T. (2010). Practical guide to creating better looking process maps. Retrieved from http://www.isixsigma.com/tools-templates/process-mapping/practical-guide-creating-better-looking-process-maps/

iSixSigma’s website offers a practical guide with many tips for creating an easy-to-follow process map.

NHS Institute for Innovation and Improvement. (2010). Quality and service improvement tools: Process mapping—an overview. Retrieved from http://www.miltonkeynesccg.nhs.uk/resources/uploads/files/NHS%20III%20Handbook%20serviceimprove.pdf

The NHS article outlines the importance of process maps and provides a detailed description of how to create a process map.