NUR 514 Discuss some system thinking tools nursing leaders can apply to increase interprofessional collaboration to benefit patient outcomes or organizational initiatives

NUR 514 Discuss some system thinking tools nursing leaders can apply to increase interprofessional collaboration to benefit patient outcomes or organizational initiatives

Interprofessional Education Collaborative (IPEC)

In 2009 six national education associations of schools of health professions representing higher education in allopathic and osteopathic medicine, dentistry, nursing, pharmacy, and public health formed a collaborative to promote and encourage interprofessional learning experiences. The Interprofessional Education Collaborative (IPEC) established common core competencies for interprofessional collaborative practice which can help guide curricula development across the health professions.

The Four IPEC IPE Core Competency Domains include:

1. Values/Ethics for Interprofessional Practice

2. Roles/Responsibilities 

3. Interprofessional Communication 

4. Teams and Teamwork

This 2016 update reflects the changes that have occurred in the health system since the release of the original report, two of the most significant of which are the increased focus on the Triple Aim (improving the experience of care, improving the health of populations, and reducing the per capita cost of health care) and implementation of the Patient Protection and Affordable Care Act in 2010.

The World Health Organization (2018) identifies that interprofessional collaboration in education and practice is an innovative strategy in mitigating the global health crisis… Collaborative practice occurs when multiple health workers from different professional backgrounds work together with patients, families, care givers, and communities to deliver the highest quality of care.

You can utilize the description of the core competencies to help support your posts this week!

References:

American Association of Colleges of Nursing. (2011). Core competencies for interprofessional collaborative practice: Report of an expert panel. https://www.aacnnursing.org/Interprofessional-Education.

Interprofessional Education Collaborative. (2016). Core competencies for interprofessional collaborative practice: 2016 update. https://www.ipecollaborative.org/ipec-core-competencies

World Health Organization. (2018). Collaborations and partnerships. http://www.who.int/about/collaborations/en/.

Designing healthcare delivery system change at the advanced nursing practice level will involve a number of leadership attributes. These attributes include an understanding of organizational behavior as well as an appreciation for the utility of various theoretical foundations necessary to support practice and research. According to Sargeant (2009), theories aid understanding and implementation of interprofessional education. Using complexity theory, Sargeant makes the case for future interprofessional collaboration among healthcare delivery system team members. As a leader in healthcare delivery system change and advancement of informatics in nursing practice, the advanced practice nurse can provide much-needed direction for the future of effective healthcare, but will need to evidence the knowledge, skills, and integrative abilities associated with such organizational theories as complexity, chaos, change, and innovation.

Thank you for such a great first week of discussions!

References:

Sargeant, J. (2009). Theories to aid understanding and implementation of interprofessional education. Journal of Continuing Education in the Health Professions, 29(3), 178–184.

Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS NUR 514 Discuss some system thinking tools nursing leaders can apply to increase interprofessional collaboration to benefit patient outcomes or organizational initiatives:

Physician shortages, increased demand for highly specialized nurses, a great emphasis on primary health care, and home-based services, and the increased acuity and complexity of hospitalized patients are among the issues motivating decision makers to rethink provision of health-care services. There is also a predicted global deficit of 12.9 million physicians, nurses, and midwives by 2035!

Consider these factors contributing to international growth in advanced nursing practice:

·     Escalating disease burden worldwide: Communicable and noncommunicable disease

·     Increased inpatient acuity and complexity of treatment

·     Impact of technological innovations and new therapeutic approaches

·     Increased emphasis on PHC and community-based services

·     Increasing requests for and complexity of home-based care

·     General global shortage of health-care workers stimulating consideration of skill mix, task-shifting, and task reallocation options

·     Physician shortages

·     Increased demand for specialized nurses

·     Nursing’s desire for a clinical career ladder and professional advancement

·     Better-informed health-care consumers

·     Intensified demand for options to address out-of-control health-care costs

·     Search to improve quality of and access to health-care services

From this list, which would you consider close to your own personal goals for advancing your degree and developing your skills as an advanced practice nurse?

Thank you for sharing!

References:

DeNisco, S. M. (2021). Advanced Practice Nursing: Essential Knowledge for the Profession. (4th ed.). Jones & Bartlett Learning

When looking at the prospective physician and nursing shortages, especially in specialty and high acuity areas, I think a systems approach is the best way to think about this situation. Many systems thinking tools allows for mapping and reflection of changes that have occurred (Wilkinson, et al., 2018). I am curious, “What has happened to all the nurses and physicians?” We can look at this system and try to find, are nurses leaving the profession? Are they simply moving to less acute areas in nursing? Are fewer people considering a career in nursing or medicine all together? The list of questions are endless! When looking toward the future as a nurse educator, I wonder what challenges lie ahead. How can we innovate RN entry education to create more advanced nurses? Can we make changes to the way we educate and view our students to encourage to improve nursing as a whole? Systems thinking in healthcare is still in early stages, but I think we will see a great increase in its need and implementation (Wilkinson, et al., 2018).

Wilkinson, J., Goff, M., Rusoja, E., Hanson, C., & Swanson, R. C. (2018). The application of systems thinking concepts, methods, and tools to global health practices: An analysis of case studies. Journal of Evaluation in Clinical Practice, 24(3), 607–618. https://doi-org.lopes.idm.oclc.org/10.1111/jep.12842

Dr. Buchanan, two things that I believe directly affect me are two that go hand in hand. I am currently employed at a skilled nursing facility, daily we admission coming in with comorbidities, but they cannot be admitted until we know their COVID 19 status. Are they COVID positive or negative, have they had their boosters, what level of precautions will they be on upon arrival and on isolation for how long. All the questions have to be attended to before we can even take care of their general state of health / reason for admission. The worldwide pandemic is still “in your face” nearly 3 years after we first experienced the horror of COVID 19. Once those issues are covered, we can then focus on a nursing care plan to promote healing or slow worsening of their actual diagnosis. I say diagnosis, but truthfully, these days it is never as simple as that. Comorbidities exist in nearly 100% of patients, even the ones just being admitted short term for therapy. There is truly an increase in acuity and complexity of treatments. A patient with a broken hip being admitted status post hip arthroplasty also has diabetes and congestive heart failure with orders for oxygen. It can be overwhelming. My goal is to work hard to implement a system to lessen the strain on the direct care nurse. Ultimately what I’d like to see is a change in the standard requirement of patient load. All too often our nurses burn out and this is a tragedy.

LaChrisa, you bring up a good point regarding the fact that an increasing number of patients who access our current healthcare system have an increasing number of comorbidities. Shi and Singh (2021) state that each chronic condition a patient has increases the cost of their medical care by a factor of three. This identifies a key area where intervention could lead to significant cost savings. In the area where I live a new program was started called “Hospital at Home” that helps to free up acute in patient beds by transferring patients home who are stable but still need frequent medical care. These patients almost always have multiple comorbidities and need more medical care than just being at home alone, but don’t necessarily need 24/7 nursing care. These patients get a physician visit daily and a nursing visit twice daily in their home. This program cuts down on the medical costs associated with in patient hospital stays, and seems to have the potential to help to manage patients with comorbidities more efficiently. This program typically acts as a bridge from acute in patient stays to either home care or hospice care. I think that more of these types of programs are needed to address the needs of both patients with multiple chronic comorbidities and patients who need acute in patient care.

Reference

Shi, L. & Singh, D. A. (2021). An overview of U.S. healthcare delivery. In S. M. DeNisco (Ed.), Advanced practice nursing: Essential knowledge for the profession (4th ed., pp. 177-210). Jones & Bartlett Learning.

Nurse leaders of today handle a variety of tasks that are riddled with baffling uncertainty and startling depth. Problems are rarely simple and uncomplicated. Leaders usually need certainty and simplicity in their plans in order to survive, yet this mentality can result in false assumptions. Success in these circumstances demands a different perspective. Understanding the interrelationships between elements, change patterns, and structures that support complex circumstances requires the knowledge foundation, theory, and methodology of systems thinking.

In order to understand how their choices and deeds as caregivers affect the overall health of the organization, nurse leaders might apply systems thinking. Systems thinking is a self-awareness technique where the nurse acknowledges interdependency limits, personal effort, authority reliance, and scientific judgment (Phillips et al., 2018). Nursing professionals might decide to mobilize change for the benefit of the system based on their knowledge and foresight. Excellent leaders among nurses may improve practice and guarantee that performance requirements are reached.

Systems thinkers are conscious of the present system, grateful for its underlying practices and structures, ready to seek systems and boundaries in spite of existing hierarchies, and conscious of the linkage between system relationships and system enhancements. The application of systems thinking has the potential to alter healthcare. Better and safer patient care is the end consequence, going beyond the cycle of quality improvement (Notarnicola et al., 2018). A sense of purpose, as well as recognizing and appreciating the potential of error-free care, can foster workplace joy. If we keep raising the caliber of our work, we will be able to provide patients with better and safer care.

References

Notarnicola, I., Stievano, A., Pulimeno, A., & Rocco, G. (2018). Systems thinking, Complex Adaptive Systems and health: An overview on New Perspectives for Nursing Education. Methodologies and Intelligent Systems for Technology Enhanced Learning, 8th International Conference, 285–292. https://doi.org/10.1007/978-3-319-98872-6_34

Phillips, J. M., Stalter, A. M., Winegardner, S., Wiggs, C., & Jauch, A. (2018). Systems thinking and incivility in nursing practice: An integrative review. Nursing Forum, 53(3), 286–298. https://doi.org/10.1111/nuf.12250

Systems thinking is essentially a theory used to holistically investigate factors and interactions that contribute to a possible outcome (Morganelli, 2020). Too add it is looking at how individuals can work together in different ways, in different environments and create the best possible processes to accomplish just about anything (Morganelli, 2020). In one of our resources the Nursing Management Journal the authors use an analogy to describe the systems thinking theory comparing it to a pebble dropping into a pool of water showing how a single nurse’s actions can affect a whole (Stalter & Mota, 2018). Going off of that analogy you could see how the systems thinking helps a leader build strong interprofessional and organization relationships. Although I do believe one later can make a significant difference, I believe that it takes followers of that leader to create good outcomes.

Interprofessional Educational Collaborative Competencies seek to guide this interprofessional collaborative practice among healthcare professionals (Interprofessional Education Collaborative, 2016). I currently work in oncology. In oncology there are multiple teams to collaborate with there is teams for medical oncology, surgical oncology, radiation oncology just to name a few. Each patient’s cancer diagnosis is unique and requires collaboration between all of these teams to create an effective treatment plan. Sometimes these patients with cancer are part of this healthcare journey and battling for many, many years. Nurses have an important job of collaborating and following through with all of the decisions that these teams make together. I have witnessed first-hand both the positive outcomes of interprofessional collaborative practice with professionals and the negative outcome if it is not done properly. Communicating with interdisciplinary members in a timely manner is essential to provide efficient effective care and to save lives. This communication is not only essential for the patient but essential for nurses and other healthcare workers to have successful/fulfilling careers.

References

Interprofessional Education Collaborative. (2016). Core competencies for interprofessional collaborative practice: 2016 update. https://www.ipecollaborative.org/ipec-core-competencies

Morganelli, Marie (2020, March 18). What is Systems Thinking? Southern New Hampshire University  https://www.snhu.edu/about-us/newsroom/business/what-is-systems-thinking

Stalter, A., & Mota, A. (2018). Using systems thinking to envision quality and safety in healthcare. Nursing Management, 49(2), 32-39. https://doi.org/10.1097/01.NUMA.0000529925.66375.d0