The scope of nursing practice is extensive. Whether nursing functions involve direct patient care, public health education, research, or even management duties, it is expected for nurses to act based on their critical thinking capabilities (Mahoney, 2001). Nurses must be proactive decision-makers and problem solvers. The foundation of astute decision-making and a thorough nursing care plan is a keen assessment of any scenario. Excellent nurses are perceptive to the ever-changing environment, economic trends, staff development, and health issues. Competent nursing supervisors apply methodological tools to accurately evaluate the current situation within their respective units. The most common method used is the SWOT matrix.
The careful assessment of both the internal and external environment is done through the identification of the unit’s strengths, weaknesses, possible opportunities, and threats (Dunn, 2010). This evaluation could help both managers and staff nurses to focus on key issues for better planning and collective decision-making. In this light, I hope that my proposed SWOT analysis could serve as an initial step in the planning stage.
The existing health policies and current hospital protocol are major strengths of the hospital. All nursing units are advised to comply with the pay-for-performance system in-home health and Medicare inpatients. This progressive movement in the health insurance system benefits the patients and medical providers. Because of this policy, the patients are assured of premium healthcare services. On the other hand, the hospitals can minimize operational costs, generate funds and enhance the quality of service by instilling to the staff the importance of meeting set performance measures for efficiency and quality.
The WHO’s International Classification of Disease (ICD-10) is also essential in upholding standards of healthcare delivery. This program ensures the monitoring system for disease burden and surveillance is at par with the international standards of medical practice (WHO, 2004). Meanwhile, mandatory MRSA screening is an effective surveillance tool to reduce the magnitude of the disease by prompt diagnosis and appropriate nursing interventions.
Seeing the importance of proper documentation in nursing care, core changes are being made to improve the documentation process. It is also commendable for the nursing units to adapt changes in the fire code system to enhance the general safety of employees and patients alike. Lastly, the financial department devises a strategy to decrease potential loss by contracting a recovery auditor.
While the institution has its strengths, there are still some flaws or weaknesses in its present system. For instance, the insurance system is at fault for failing to include patients, aged 21 years old and above, in the Medicaid coverage. Lack of patient privacy and inadequate security still exist in the ward. This is a major weakness since nurses should practice bioethics at all times. The rights of patients to privacy and safety should be not violated. The lack of radiology certification of some staff is a likewise drawback from the perspectives of quality assured health services provision.
Several potential opportunities can be integrated during consultative planning. One possible milestone is the prospect of nurse practitioners prescribing controlled substances in the future. The impact of this change can produce a paradigm shift in the scope of nursing practice. The other opportunities which can be cited are the following: First, the nurse manager may want to look at the possibility of adapting the EMR system which is currently implemented in some states.
Proposals of feasibility studies to select a compatible system that is fully interfaced/integrated with the hospital system could be undertaken by ward nurses and initial results could be presented during management committee assembly. Staff development is also a vital component in an organization; hence, each ward could have unit discussions, massive reeducation, and possible training for the staff to minimize the knowledge gap on ICD-10 and ensure guidelines compliance.
In addition, supervisors can advocate for staff to be trained and to receive radiology certification. Staff nurses could assist in the recovery of reimbursement received for observation cases and some short inpatient stays through proper documentation and good record keeping in the wards. Finally, regular fire drills and disaster management discussions in the wards, while the installation of an additional fire prevention system is in progress, can augment the hospital’s fireproof plan.
The nurse supervisors and administrators should be wary of other external factors which can be classified as threats. The drawing of alternative solutions should be a part of planning. There is a possibility that some of the physicians and/or staff nurse practitioners will oppose the proposed changes in the ward or become late adopters. A discourse between management and staff may ensure because of differences in opinion.
Conflict management techniques and open dialogue between managers and staff nurses could be used to re-establish order. The actual activity costs can also be a problem. At times, the actual expenses exceed the projected budget. For example, the price of EMR equipment and diagnostic tests for MRSA may rise and go above the allocated funding for these projects. The lack of reimbursement for the tests and MRSA education may result in poor acceptability and service satisfaction among staff. The limited Medicaid coverage can produce severe damages to the institution. The hospital may suffer revenue loss and an increase in non-reimbursed care.
To prevent more profit loss, the hospital may opt to execute extreme measures. The nurses should be ready for worst-case scenarios such as possible retrenchment and additional workload due to an imbalanced patient-nurse ratio. Lastly, changing the present documentation and record-keeping system can be an arduous task for overworked staff. Adaptation and full implementation of new record forms, surveillance materials, and lack of homogeneity in the physicians’ documentation would entail an adjustment period.
Planning is regarded as the most fundamental of all management functions. Organizing, monitoring, and evaluation will not be successful without a sound plan. This process of decision-making must start with a full understanding of the four aspects of the Strengths, Weaknesses, Opportunities, and Threats matrix. Ultimately, even though SWOT analysis is only a fraction of strategic management, the SWOT matrix is a good framework for reviewing strategies, positions, and direction of a health organization (Chapman, 2011).
References
Chapman, A. (1995-2011). SWOT analysis: methods and examples. Web.
Dunn, R., & Haimmann, T. (2010). Healthcare Management (9th ed.). St. Louis, Mo: AUPHA and Health Administration Press.
Mahoney, J. (2001). Leadership skills for the 21st century. Journal of Nursing Management, 9:269-71.
World Health Organization. (2004). International statistical classification of diseases and health related problems. Web.