Introduction
The process of solving problems that affect different aspects of healthcare can be approached from a variety of theories developed in existing scholarly research. For example, the open systems approach may be used to analyze issues in a department or an organization because this theory can help systematize factors contributing to successful nursing care. One of the concerns that are present in my clinical setting is the lack of effective communication between physicians and nurses, which leads to lower patient and job satisfaction levels and increased rates of mistakes and disagreements between staff and doctors (Gordon, Deland, & Kelly, 2015). Thus, an open systems theory should be utilized to assess the problem of unproductive interactions and propose a solution that addresses the issue while staying adherent to the organization’s mission and values.
Problem Description
Unit Specifications
The described part of the healthcare organization is a non-intensive medical unit. According to the system concepts, the inputs in this unit are represented by staff, physicians, and care recipients (Meyer & O’Brien-Pallas, 2010). Apart from people, inputs also include various resources, funding, equipment, and information about the market and the external environment. In this case, the staff consists of nurses and administrative personnel. Physicians also play a significant role in developing the department’s quality of care. The hospital is a not-for-profit organization which means that most funding sources are directly connected to the community and its primary stakeholders. Similarly, the equipment used in hospitals is also dependent on public funding efforts. Informational inputs suggest that the staffing problem exists on the market.
The throughput of the clinical setting includes all processes and services initiated with the help of existing inputs. Thus, the performance of the unit is the combination of the organization’s large size, not-for-profit type, and structure, and ideology focused on affordable and accessible care (“Mission, vision & values,” 2018). Management practices and communication between staff members are also a part of throughput. Furthermore, the use of existing technology and staff’s qualification is significant as well. The size of the particular hospital is not large, thus, allowing an approach to be more focused on individual patients. However, the model of care is similar to a teamwork-based approach that helps nurses implement their best skills. Thus, coordination between the staff is rather efficient, which cannot be said about the interactions between nurses and physicians.
The outputs of the organization are defined by clinical, professional, and organizational outcomes. Patient safety and satisfaction are decreased because of ineffective communication, which often leads to errors in care delivery. Nurses also voice their concerns about job satisfaction, as their relationships with doctors do not exhibit any characteristics of teamwork and mutual understanding. The quality of care in the organization suffers as a result, providing negative feedback with poor performance indicators. The efficiency is decreased because physicians and nurses take more time to understand each other and patients’ needs. Thus, resources may be used ineffectively with duplicated tests or missed care. As the outputs are strongly affected by this problem, the cycle of events has many issues as well and cannot establish a productive sequence.
Detected Problem
After describing the processes and resources of the organization, one can detect the area of the system which needs to be improved. In this case, the unit has a problem in its throughput processes –communication between nurses and physicians is ineffective because of poor coordination and integration efforts. It is possible that nurses’ schedule does not align with one of the practitioners, making their collaboration sporadic and unbalanced (Kowitlawakul et al., 2015). The problems of hierarchical relationships and nurses feeling as though they are unable to contact a doctor may also contribute to this issue (Gotlib Conn, Kenaszchuk, Dainty, Zwarenstein, & Reeves, 2014). Overall, poor communication is a problem of the maintenance subsystem responsible for the socialization of workers and the systematization of their practices. An open systems theory implies that all workers are able to interact with each other and contribute to the decision-making process. However, the described problem does not support such practices and needs to be resolved.
Problem Solving
The issue of ineffective communication can be resolved at the organizational level. The desired outcome would be to improve interactions between nurses and doctors by making them systematized and regular. For this purpose, a number of strategies can be suggested. First of all, it is necessary to identify small objectives that would lead to the primary goal of establishing nurse-physician collaboration. Nursing personnel and doctors need to evaluate their relationship with each other and find areas of communication that require more attention. For example, some units may have problems in the handover process that stem from insufficient information being included in the official documents and personal communications (Kowitlawakul et al., 2015). In other departments, workers may lack time to meet and communicate on a regular basis (Henkin et al., 2016). Finally, the exchange of information may be ineffective because different specialists use unclear wording or do not follow standardized procedures for patient assessment.
Thus, to reach the first objective – identifying the primary concern, nursing managers need to collect necessary data and present it to the unit’s workers, encouraging further discussions. Next, ways to resolve the problem may be reviewed. For example, a new health information technology (HIT) may contribute to better communication between staff and doctors because it will supply both sides with identical information that adheres to the established standards of care (Manojlovich et al., 2015). HIT is an effective way to assist employees in exchanging data. The procedure of using a computerized system on an exclusive basis may systematize all documents in one place and reduce the possibility of misunderstandings between employees. Furthermore, one can suggest interprofessional meetings with patients as a way to encourage communication (Henkin et al., 2016). The process of collaborative bedside rounding can be turned into a new policy for the unit.
The proposed changes correspond to such professional standards as knowledge-based practice and person-centered care because they use existing research that values patient outcomes and nurses’ job satisfaction levels. The discussed unit’s values are focused on providing care to patients in a holistic and accessible way which cannot be done if health care providers do not interact with each other. Thus, the discussed policies and procedures directly contribute to improving the organization’s climate and culture while being coherent with its ideology.
Conclusion
The problem of ineffective communication between nurses and doctors is a throughput issue, according to the open system approach. It can significantly affect all aspects of healthcare and negatively impact patient and organizational outcomes. To resolve this issue, nursing managers can suggest implementing a more effective HIT system and create policies that would encourage systematized exchanges of information and collaborative bedside routing. These activities may reduce the number of errors from misunderstandings and support effective communication between workers. The unit’s climate and culture can be improved as a result of these interventions, which directly relate to the organization’s focus on accessible and holistic care.
References
Gordon, J. E., Deland, E., & Kelly, R. E. (2015). Let’s talk about improving communication in healthcare. Columbia Medical Review, 1(1), 23-27.
Gotlib Conn, L., Kenaszchuk, C., Dainty, K., Zwarenstein, M., & Reeves, S. (2014). Nurse–physician collaboration in general internal medicine: A synthesis of survey and ethnographic techniques. Health and Interprofessional Practice, 2(2), eP1057.
Henkin, S., Chon, T. Y., Christopherson, M. L., Halvorsen, A. J., Worden, L. M., & Ratelle, J. T. (2016). Improving nurse–physician teamwork through interprofessional bedside rounding. Journal of Multidisciplinary Healthcare, 9, 201-205.
Kowitlawakul, Y., Leong, B. S. H., Lua, A., Aroos, R., Wong, J. J., Koh, N.,… Mukhopadhyay, A. (2015). Observation of handover process in an intensive care unit (ICU): Barriers and quality improvement strategy. International Journal for Quality in Health Care, 27(2), 99-104.
Manojlovich, M., Adler-Milstein, J., Harrod, M., Sales, A., Hofer, T. P., Saint, S., & Krein, S. L. (2015). The effect of health information technology on health care provider communication: A mixed-method protocol. JMIR Research Protocols, 4(2), e72.
Meyer, R. M., & O’Brien-Pallas, L. L. (2010). Nursing services delivery theory: An open system approach. Journal of Advanced Nursing, 66(12), 2828-2838.
Mission, vision & values. (2018). Web.