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EDD FPX 8010 Assessment 4 Quality Improvement Proposal

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EDD FPX 8010 Assessment 4 Quality Improvement Proposal Student Name Capella University EDD-FPX8010 Foundations of Doctoral Studies in Education Professor Name Submission Date Quality Improvement Proposal Slide 1 Hello! My name is ____. I am introducing the quality improvement project that was chosen as a strategic focus of the behavioral health department of Albany Medical Center. Slide 2 Executive Summary One of the most critical areas that will have high-level quality improvement to maintain the Magnet status and improve patient outcomes has been identified as the behavioral health department of Albany Medical Center. The strategic plan will focus on such priorities as transformational leadership, structural empowerment, and exemplary professional practice (Kleine et al., 2024). In order to maintain Magnet accreditation, the department aims to increase the national presence even more, improve well-being among the staff, and improve the standards of the care offered to the patients. The Lewin change theory would therefore come in handy in the change management process, including the incorporation of all the stakeholders (Endrejat & Burnes, 2022). The SWOT analysis is conducted to evaluate the strengths, weaknesses, opportunities, and threats (Puyt et al., 2023). The fresh policy on quality improvement will be included in the program, and more recent approaches to the training and development of the staff. The old practices will be stored in case the departmental practices are streamlined to the overall objectives and standards of the hospital. The enhancement of internal processes will be done with the help of nursing simulation centers, and ongoing learning and development will be stimulated by nursing scholarship and evidence-based practice (King et al., 2021). The organizational policies are well synchronized with the strategic objectives of the department so that there is a singular way of enhancing patient outcomes, performance of the staff, as well as making the best use of resources. Slide 3 Quality Improvement Proposal The quality improvement proposal of Albany Medical Center behavioral health department is a patient waiting time decrease to promote an efficient scheduling process as one of the strategic priorities to improve. The enhancement will be aimed at improving access to behavioral health services using technology-based solutions, including telehealth services and state-of-the-art scheduling software. The department aims to minimize waiting times in appointments in order to improve patient trust and satisfaction and deal with the growing demand in mental care (Hospital Safety Grade, n.d.). The proposal emphasizes collaboration between mental health practitioners and nurses and information technology (IT) specialists to promote the seamless integration of such technologies (Isidori et al., 2022). The program helps the department meet its strategic goal of offering economical, prompt and equal behavioral health services based on the mission which focuses on enhancing the health outcome of the community by Albany Medical center. Slide 4 The Rationale for Establishing a Strategic Priority The reasoning behind the strategic direction of decreasing patient wait times within the behavioral health department is that there is growing demand of timely mental health services. The wait times may lead to worsened mental health problems, then the patients may cease to be engaged in care, which has more significant impacts in underserved groups (Sanderson et al., 2020). This would be the priority of the mission of the department, which is to enhance community access to equitable cost-effective behavioral health services and health outcomes overall (Hospital Safety Grade, n.d.). The overall goal of the proposed quality improvement initiative is to make the scheduling process more streamlined and to start telehealth services to reduce wait times, thereby increasing and enhancing care delivery to behavioral health patients. Its emphasis is on two aspects: the streamlining of patient appointments through technology (telehealth platforms and advanced scheduling systems) and interprofessional collaboration between the staff to make sure that such systems are implemented properly. The literature on evidence-based sources is critical on the fact that there is a dire need to have timely access to behavioral health services. Tele-based solutions have been shown to offer patients in remote or poorly served areas additional access to services and improve their use (Butzner & Cuffee, 2021). The proposal matches findings proving that innovative service delivery models can help bridge the gap in mental health care while being consistent with Albany Medical Center’s and Department goals. Implications and Consequences The mentioned priority to minimize wait times of patients in the behavioral health department has a range of logical implications and consequences that have a substantial influence on the delivery of care. On the bright side, the priority can improve patient access to prompt mental health care, minimize the worsening of undiagnosed conditions, and overall improve patient satisfaction and trust (Sanderson et al., 2020). Less waiting time also leads to higher patient outcomes since early intervention and follow-up are the most important factors in addressing mental health issues accordingly. Moreover, telehealth use and effective time management systems will help gain maximum out of the available resources and increase staff efficiency, which will also guarantee the financial sustainability of the department (Butzner and Cuffee, 2021). Such practices would also be expensive to implement and much of the staff would have to be trained on the new technology and this could, in some cases, lead to resistance by the staff and other patients. The implementation is prone to experience delayed implementation and staff and patient dissatisfaction without a proper and timely solution (Robinson et al., 2020). But with a successful execution, the wait time reduction priority will create a more responsive, fair and patient centered behavioral health service that aligns with the strategic objectives of Albany Medical Center. Slide 5 SWOT Analysis Strengths Albany Medical Center has exhibited a number of strengths resonating with strategic priorities to enhance patient satisfaction and expand access to care. The institution boasts of a well-developed infrastructure to implement telehealth services, with strong electronic health records (EHR) and convenient person-scheduling systems (Hospital Safety Grade, n.d.). In addition, the institution has a highly trained staff that is equipped with behavioral health expertise that makes it self-assuring and provides quality care.

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EDD FPX 8010 Assessment 3 Strategic Plan Development

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EDD FPX 8010 Assessment 3 Strategic Plan Development Student Name Capella University EDD-FPX8010 Foundations of Doctoral Studies in Education Professor Name Submission Date Strategic Plan Development Developing a strategic plan is essential to make significant improvements in the existing healthcare services. Strategic planning will assist the hospital management in enhancing the level of quality of care, which will eventually result in patient trust and satisfaction. The behavioral health department of Albany Medical Center will be given the strategic plan and departmental priorities in the assessment. Also, the significance of the organizational policies in developing the strategic priorities is provided. The congruence of the behavioral health department with the general strategic plan of the hospital will be discussed based on the balanced scorecard (Albany Medical Center, n.d.). The Albany Medical Center’s mission is to meet the healthcare needs of the community by expanding healthcare services through the community health improvement plan. Departmental Strategic Priorities The Albany Medical Center behavioral health department came up with strategic priorities to enhance the accessibility of behavioral and mental health services in the community. The first strategic priority is to expand the community’s access to cost-effective behavioral services to enhance community access to services (Albany Medical Center, n.d.). To provide cost-effective services to the community, an initial investment is necessary. Allocation of resources for expanding behavioral healthcare services helped in attracting more patients, improving the financial stability of the department. The second strategic area is to lower the time it takes to wait after patients have been scheduled by simplifying the scheduling process (Albany Medical Center, n.d.). Within the behavioral department, as a measure to cut down on the wait time, one of the technologies that will be employed includes telehealth-based services that will be used to provide remote care to the patients, hence cutting the time taken to wait. The third departmental strategic priority is to ensure that the behavioral department develops a culture of interprofessional collaboration that will help provide the patients with effective care. The hospital staff, such as the mental health personnel, pharmacists, nursing staff, and information technology staff, will work together to offer remote care to the patients. Interprofessional collaboration between the staff helps in delivering effective care to patients, improving health outcomes (Wei et al., 2020). The fourth strategic priority of the behavioral department is the introduction of a cultural competency training program to the healthcare staff, especially the mental healthcare professional (Albany Medical Center, n.d.). The training will enable the staff members to deliver care services with consideration of the cultural beliefs of the patient to increase trust and satisfaction with behavioral healthcare services. The departmental priorities are the possible and significant ones to enhance the above standards of care quality of the behavioral department at the hospital. The developed priorities underscore the need for resources to deliver effective behavioral care to patients that are synchronized with the availability of the resources allocated for the department. Further, the priorities also mirror the congruence with the objectives of the hospital to promote excellent care to increase patient satisfaction and trust (Albany Medical Center, n.d.). Moreover, the opportunity for enhancement by leveraging the technology and conducting the staff training program also showed the department’s commitment to enhancing the quality of care. The priorities are significant, therefore, because of the compatibility with the strategic plan of the hospital to increase the quality of care and patient satisfaction. Organizational Policies Policies in organizations create regulations that assist and guide the normal functioning of the behavioral department of Albany Medical Center. The behavioral department underscores the need for equitable delivery of behavioral services to the community to develop people’s trust in the services. One of the policies that enables the operations of the behavioral department is resource allocation. The resources allocated to the expansion of behavioral care will help deliver fair care to patients with behavioral problems, making health outcomes and quality of life better (Miller et al., 2023). The interprofessional coalition is another policy that helps the department to proceed with the operation and provide effective care to patients. The healthcare staff, specifically mental health professionals, nursing staff, and pharmacists, join forces to come up with a coordinated care plan to achieve better health outcomes when it comes to managing behavioral issues (Reist et al., 2022). The collaboration aided in delivering effective care to patients and increased patient trust and satisfaction. Some of the policies that negatively affect the usual operations of the behavioral department are the rigorous hierarchical structure. Policies that give preference to the hierarchical system are counterproductive to the functioning of the behavioral department. The hierarchical structure delays the decision-making process and does not allow implementing quality improvement measures (Fernandopulle, 2021). Therefore, the behavioral department encounters obstacles to establishing new programs to enhance the quality of care. Additionally, the policy for change in practices also brings barriers for the department due to budget constraints (Wang et al., 2023). The change in practices is needed after a few years to improve the quality of care. Nevertheless, the conflicting interests with the rest of the departments introduce financial limitations that limit the department in achieving the target goal. Implications and Consequences There is a need to understand the implications and the effects of policies on the performance of the department. For example, resource allocation and collaborative care policies have positive implications on the behavioral department. Proper resource allocation will help the department to enhance and change the quality of care and eventually increase patient trust and satisfaction (Miller et al., 2023). Moreover, the promotion of a collaborative practice of care improves the level of care quality. The effects of the policies are an increase in patient trust and satisfaction through the provision of efficient behavioral health care services. Policies that limit the department’s function, such as hierarchical system policy and changes in practices, have negative implications and outcomes. With a hierarchical system, the department is unable to enhance its functionality because of the delayed decision which impacts department functions and

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EDD FPX 8010 Assessment 2 Strategic Plan Appraisal

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EDD FPX 8010 Assessment 2 Strategic Plan Appraisal Student Name Capella University EDD-FPX8010 Foundations of Doctoral Studies in Education Professor Name Submission Date Strategic Plan Appraisal Strategic plan appraisal refers to the evaluation of the strategic plan of an organization in order to determine the suitability, efficiency, and results of the strategic plan. The strategic plan analyses the strategic goals, objectives, and performance of the organization. The plan aids in ensuring compliance with the mission and vision statement of the organization and examines the external factors that can be used in formulating future strategies. Credibility, the involvement of stakeholders, and the balanced scorecard of Albany Medical Center will be looked into in the analysis (Albany Medical Center, n.d.). The current strategic plan and implementation of the hospital will be discussed in the review. Organization Strategic Plan Strategic Plan and Priorities The 2022-2024 Community Health Improvement Plan (CHIP) of the Albany Medical Center covers health needs of the community based on interconnected health priorities. Prevention of chronic diseases is the first priority. The second priority will be to promote mental health and substance use prevention. The third priority is to enhance the health of women, infants, and children (Elizabeth et al., n.d.). A systems perspective supports the task of controlling diabetes and obesity with the help of wellness programs at the worksite and food security programs. The priorities offer an interrelationship between the public health interventions and the systemic health determinants (Elizabeth et al., n.d.). The strategy combines clinical care, education, and community-based programs, which puts the community at the centre of the initiative to address both upstream and downstream health determinants. Precedence of Priorities CHIP has strategic priorities that put mental health and chronic disease prevention as its first priority. Thus, the two regions seem to be priorities. Raising the level of behavioral health, better access to medication-assisted treatment (MAT), and suicide prevention programs are all indicators of an urgent reaction to the rising mental health and substance use problems (Elizabeth et al., n.d.). At the same time, the measures in the field of chronic disease prevention, including breastfeeding support, asthma control, and better diabetes treatment, are oriented towards community health matters (Elizabeth et al., n.d.). Priorities are also aligned with the top health needs that the community has identified during health assessment, as well as indicating an interest in food insecurity and tobacco use, which also exacerbates a disparity in health. Alignment with Mission and Vision The priorities align with the mission and vision of the center, which is focused on excellence in care, education, and research to improve the health and well-being of the community. The plan focuses on enhancing access to care and managing the social determinants of health, which is in line with the goal of the organization to provide comprehensive health services (Albany Medical Center, n.d.). The vision of the plan also incorporates the vision of the center to be a community health advocate by actively working with local stakeholders, including schools, businesses, and nonprofits, to develop sustainable health solutions. The alignment focuses on the institution as a hub of health improvement for communities. The center’s plan is a systems approach that is aimed at complex health issues. The focus of the plan is mental health, chronic disease prevention, and maternal and child health areas that are significant community needs, fitting well with the overall mission and vision of the organization (Albany Medical Center, n.d.). The equity, access, and collaboration strategic plan that supports the long-term and sustainable nature of the medical center in improving the health of the community. Validity of Data and Analytical Strategies The 2022-2024 plan at the Albany Medical Center will involve the use of both internal performance indicators and external public health data to build the key performance indicators (KPIs) and priorities of the organization. Data for patient satisfaction, readmission from the hospital, and outcomes in managing chronic diseases would be major internal data points. The data points that lead towards the direction of the enhancement of behavioral health access and chronic disease prevention. The patient experience rating of the center is 2 out of 5 (based on the surveys of discharged inpatients) (Hospital Compare Score, 2024). The scores were based on the way the patients perceived hospital stay and discharge, and the level of satisfaction of the patients regarding different aspects of care. The sources of the metrics data probably comprised both internal and external data. Internally, the center could have used electronic health records (EHRs), patient satisfaction surveys, and hospital utilization reports. Externally, the Medicare Compare data would have come in handy in showing the trend in the prevalence of mental health issues, substance use disorders, and chronic diseases. The Albany Medical Center has a Medicare Compare score of 14.1% (meaning 4173 patients) in the rate of admission after discharge (Medicare, 2024). The Medicare patient survey rating is 2 out of 5, based on patients’ experiences of their hospital care (Medicare, 2024). The Leapfrog survey rated the center as having a harmful events score of 1.18, in contrast with the best hospital score of 0.55 (Albany Medical Center, n.d.). The score demonstrates the hospital’s effectiveness in averting complications and adverse events following surgeries or procedures, and childbirth. The highest score of the center was 0.781 on patient falls, and the lowest scores were 0.000 and 1.942 on the worst-performing hospital. Falls often occur due to patients’ efforts to walk without support and lead to extended hospital stays and permanent disability. The center has a blood clot score of 4.83 as opposed to a score of 1.61 at the best hospital (Albany Medical Center, n.d.). The blood clots, which develop in the leg following surgery, may travel to the lungs, causing chest pain, loss of consciousness, or even death. The readmission data, which involves significant financial facts about the pattern of service utilization and the costs, could have been required to reveal high areas of resource utilization (Puspoky et al., 2023). The powerful data collection/analytics approach gives

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EDD FPX 8010 Assessment 1 Political Landscape Analysis

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EDD FPX 8010 Assessment 1 Political Landscape Analysis Student Name Capella University EDD-FPX8010 Foundations of Doctoral Studies in Education Professor Name Submission Date Political Landscape Analysis Political landscape analysis is a process of identifying and examining political factors, political actors, and political power systems that could influence any given issue or policy. The process involves identification of the players and charting stakeholders’ preferences. The analysis process involves identifying those who can be of great help in the political process as well as those who may pose a threat (Campos & Reich, 2019). The main goal of the assessment is to assess the political environment in the organization through the lens of the chief nursing officer (CNO). The context includes the legal and cultural framework and organizational structure that governs communication. Formal And Informal Lines of Power The case study shows that there was an intricate combination of formal and informal power systems in the hospital system. Formal lines of power are formal structures of hierarchies in an organization, which are determined by positions and roles (Oedzes et al., 2019). Unofficial influence networks (relationships, expertise, or social dynamics) that consist of informal lines of power exist and may override formal structures (Haponenko et al., 2023). Official power lines are based on traditional organizational hierarchy, and the chief executive officer (CEO) is the leader of the organization, with the next positions of the executive leadership consisting of the CNO and chief medical officer (CMO). The board of directors also wields a lot of power, as observed in their requirements for Magnet recognition. The CMO and lower-level managers, in their departments, have authority. Physicians (particularly CMO) possess informal power in terms of power. The doctor-centred culture and power of the CMO in the medical fraternity imply that there is more power that is not officially delegated. Although advanced practice registered nurses (APRNs) do not enjoy formal power, they are wielding informal power (through collective action) when approaching the CNO. The organization has a large workforce of more than 50 APRNs, of which 15 are actively resisting the change, using the power of the collective as informal power and their essential contribution in treating patients. The 15 APRNs who go to the CNO illustrate the informal ways through which the issues and opposition can be voiced. Comprehending the power relations in order to manage the change within an organization and lead effectively is important. Sources of Stakeholders’ Power The stakeholders also present the different sources of power in the scenario. The sources of stakeholder power play a crucial role in strategic decision-making and organizational performance (Ninan et al., 2019). The CEO and board capitalize on position power and reputation, but the CMO uses a combination of knowledge, prestige, and influence due to his numerous years of service and contributions to the world. The hospitalist group employs authority power, particularly through the proposed bonus system that will be given to APRNs. Obtaining LLC status by the hospitalist group is a strategic action to increase their organizational strength because this business structure would offer them limited liability and possibly increased financial independence. On the other hand, the CMO’s proposal to limit the hospital privileges of the non-compliant APRNs is an example of coercive power. The APRNs are trying to establish their authority with the power of the group and the impact on the patients since they are the non-supervisory personnel. Implications and Consequences The organization has well-defined power structures that influence the culture of the organization, the policies set, and the communication systems in place. The culture of physicians and the position of CMO can be viewed as a contributor to the organization where the medical staff is more powerful than any other stakeholders. The gap reflects on policy-making as embodied in the proposed APRN transition and privilege policy. Oatey and Lazidou (2024) state that physician-centered cultures can contribute to the development of unequal power relations, which prevents teamwork and harmonized provision of health care services. The communication channel is most likely to be hierarchical, in which the input of physicians will be considered more than that of nurses. This is a retention issue for the CNO since the position has changed many times, which could be due to power struggle. Warden et al. (2021) have indicated that health care organizations that have power disparities adversely affect job satisfaction and turnover of nursing directors. Top management imposition of organizational goals is indicated by the pressure from the board to achieve magnet status. These types of power structures can inhibit interdisciplinary collaboration and give rise to departmental cliques. Organizational Power Influences on Executive-Level Decision-Making The nature of the concerns of the APRNs and responding to them can only be understood in terms of the existence of organizational power relations. The best response can be to support the idea of a compromise that would keep the independence of the APRNs and at the same time consider the CMO’s authority. This must begin by conducting face-to-face meetings with the APRNs to determine their issues as well as gaining insight into the impact of the proposed changes on patient care and patient outcomes. I would call a meeting with the CEO and CMO to justify the advantages of APRNs with the aim of developing a task force that will proceed to develop other potential solutions that could be appropriate to all the parties involved. It is necessary to stress the importance of a strong and independent nursing practice in the organization’s quest of the organization to re-earn Magnet status and why the hospital board must be on board with this. This is in line with the literature that recommends nurse executives exercise their power to represent the nursing workforce. Successful nurse leaders address the power culture through coalitions and using reasoning when they propose their argument (Crawford et al., 2019). I think that promoting communication and finding the middle ground may help to develop the integrated care model that will include the APRNs’ practice and accommodate the hospitalist