Situational Analysis
Steps for Undergoing Situational Analysis
The first step is to determine a framework. This means that the obtained information will be presented coherently. There are several frameworks Rashid Hospital administration may choose from. In most cases, the existing frameworks can be easily adapted to the specific needs of the organization. The current framework will include a possibility to make comparisons with other hospitals located in Dubai. Moreover, the framework is expected to highlight the exclusive feature of the fall prevention plan that is implemented within the framework of this paper.
The second step is to categorize the data that is already available to Rashid Hospital. The administration is responsible for storing all the sources of information and all the available data. This means that the available data will be analyzed and structured by the staff. The administration at Rashid Hospital believes that the statistics that were collected during the previous stage will be efficiently used throughout the time frame after the implementation of the fall prevention plan. The administration is aware of the fact that the collected information may be irrelevant or inaccurate, so the managers are used to going through the process of analyzing the obtained information and scrutinizing the latter to eliminate any inaccuracies.
The third step is presented by the process of identifying the information that is still mandatory to implement the fall prevention plan successfully. During the process of collecting the data, no significant gaps were identified. At this point, the administration of Rashid Hospital developed a set of genuine objectives related to the novel fall prevention plan. The most important thing during this step was that the staff at Rashid Hospital collected only practical data and did not wait for a perfect opportunity to publish the composed plan.
The fourth step is related to the collection of supplementary data. Moreover, it was intended to help the nurses and other staff better comprehend the key objectives of the newly developed and published fall prevention plan. The plan was distributed to the appropriate personnel, and the timeframe was specified.
During the fifth and sixth steps, the administration of Rashid Hospital compiled the final report and distributed it respectively. It was updated promptly to reflect only relevant and conversant data. The obtained data regarding the efficiency of the new fall prevention plan was shared will all the staff, and then feedback was collected.
Elements of the Internal Environment
The key element of the internal environment that was taken into consideration by the researcher is the managerial resource-based factor related to management. This aspect includes the nurses’ willingness to provide high-quality care and be a passionate health care provider. A supporting role, in this case, was given to the managerial decision-making process as the nurses’ readiness to provide eminent health care service utterly depended on the leadership style employed at Rashid Hospital.
Strengths and Weaknesses of the Competitors
The key competitors of Rashid Hospital are American Hospital Clinic, NMC Hospital, Medicare Clinic, and Emirates Hospital. These four hospitals are considered the most dangerous competitors because they all share several strengths and weaknesses that are characteristic of the majority of Dubai Hospitals. The key strengths include research interests and powerful management practices. Also, Emirates Hospital and American Hospital Clinic make the best use of their active clinical research and intermountain organization. All four hospitals carefully approach their patient population. The sixth strength is the fact of efficient collaboration inherent in these hospitals (both internal and external). The last strength is a unique reimbursement strategy that is common for hospitals located in Dubai.
One of the significant weaknesses of the hospitals mentioned above is their outdated marketing approach. Moreover, their educational practices are not as efficient as in the USA or other Western countries. The third weakness of Dubai hospitals is that they commonly do not perform follow-up assessments. Another problem is that these four hospitals feature uncredentialled physicians. The fifth weakness consists in the fact that such components of IT systems of the hospitals as protocols and databases are also outdated and rarely upgraded despite the technological progress. The last weakness relates to the referrals out of network which can be found in almost all hospitals across the Emirates.
Data Sources
Service Description
Within the framework of the current paper, the researcher concentrated on the review of the implementation of a new fall prevention plan in the cardiology department. This innovative plan was developed by the information regarding the occurrence of falls among hospital patients that were obtained by Rashid Hospital staff. The key point of improving this particular service was the fact that Rashid Hospital did not have a fall prevention plan in place before and it was interesting to see the outcomes of this innovation. Within the framework of the current research, a “fall” is defined as an unintentional loss of control (from any position) that ends up in landing on the floor or jamming into other surfaces or items. The occasions where staff members were able to prevent the patients from injuring themselves are also included. The researcher expects to track all the relevant data concerning patient falls (including the incidents where the fall did not result in an injury).
Throughout the research process, it was identified that the fall prevention plan that will be developed at Rashid Hospital should not lack several important details. Therefore, developing a flawless fall prevention plan became of the key priorities as it would allow to take over the Dubai healthcare market and nearby areas (Yoder-Wise, 2013). The new fall prevention plan was intended to function within Rashid Hospital for a month. The administration of the hospital expected to share its new fall prevention plan data with other hospitals in the area in case if it showed significant progress in comparison to other available fall prevention plans.
The administration of the hospital considered the core healthcare requirements and was able to fine-tune the existing fall prevention plan in a rather effective manner. They included the realities of the UAE into their vision and specifically addressed the issues of patient safety within Rashid Hospital. Rashid Hospital significantly improved its position in the healthcare market owing to the developed fall prevention plan. The key reason for the statement above is a well-known fact regarding the unwillingness of the majority of Dubai hospitals to renew their fall prevention plans and obtain a critical strategic advantage by doing that (Sare & Ogilvie, 2016). It can be started right away that the fall prevention plan that was developed within the framework of the current research had a pivotal impact on Rashid Hospital staff and their performance. The number of patient falls was reduced, and that might be the best explanation of why the developed fall prevention plan was an eminent one.
General Goals of the Service
The core goal of the proposed service was to improve the organizational performance at Rashid Hospital and increase the responsiveness of the hospital staff when it came to patient safety. The mission of Rashid Hospital was inherent in that goal. Moreover, the implementation of the novel fall prevention plan significantly impacted managerial approaches at Rashid Hospital and how the patients were receiving care. The development and implementation stages majorly subsidized to the staff’s interest in evidence-based care and their awareness regarding patient safety.
The second general goal was to develop a fall prevention plan that fully complied with the vision of Rashid Hospital and mirrored the core values of the organization’s employees. By implementing this particular plan, Rashid Hospital was able to improve the quality of care and several other aspects of healthcare (Persily, 2013). Another important fact is that Rashid Hospital was able to rationalize its essential principles of patient-oriented care and accomplish one more goal.
The last general goal that was developed and accomplished by Rashid Hospital staff is an in-depth analysis of the existing data regarding the incidence of falls among patients. The current project was intended to bring a strategy to life that would reflect the impact of an updated fall prevention plan. The employees were rather motivated to implement this new plan and line up their practice by it. As it was expected, the staff made an effort to help throughout the processes of researching on the topic and developing the final version of the plan (Yoder-Wise, 2013). The deployment of this project showed that the employees at Rashid Hospital are committed to providing high-quality health care services only.
Specific Objectives for the Service
Description
Some specific goals were taken into consideration by Rashid Hospital management before implementing the new fall prevention plan. The first specific objective related to improved patient safety. Rashid Hospital administration expected to investigate the problems inherent in fall-related risk factors.
Another specific goal was to standardize fall-preventing interventions. The care providers were expected to implement fall-preventive customer-centered improvements. These two factors were perceived as an opportunity to help Rashid Hospital employees understand the value of a fall prevention initiative and stabilize the healthcare environment. This specific goal was also aimed to promote the core organizational values of the hospital. By aligning their practice with this particular goal, the administration of Rashid Hospital ensured the provision of transparent care and necessary patient support.
The last specific objective was the customization of the interventions that were included in the fall prevention plan. Within the framework of the existing research, this issue was considered rather relevant because it presupposed an increased level of observation and was expected to impact the patients’ attitude toward the hospital as well. The administration of Rashid Hospital was also keen on environmentally adapting to the issues connected to fall-related injuries (Penner, 2013). Despite the evidence from the reviewed literature, the fall prevention plan that was developed within the framework of the current research was not found to impact the costs of healthcare services in a significant manner.
Consistency with the Hospital Mission
The administration of Rashid Hospital considered that the implemented fall prevention plan was consistent with the mission of the hospital. It was expected that the employment of the fall prevention plan would affect critical performance indicators. Moreover, consistency with the mission of Rashid Hospital could be witnessed in the trivial costs of the project (meaning that the hospital was intended to provide high-quality services for a fair price) (Yoder-Wise, 2013). It can also be mentioned that the consistency mentioned above was spotted in the probable impact of the employed fall prevention plan on the health care competition in the area. The core mission of Rashid Hospital was supported by the connections that were expected to improve the standing of the hospital. Other hospitals and medical experts evaluated the developed fall prevention plan and provided Rashid Hospital with their critical assessment of the service (Penna, 2015). The consistency can also be explained by the ability of the administration to motivate the employees and promote basic organizational values.
Implementation Plan
Activities Included
The implementation plan consisted of several critical stages that were accurately followed to trigger positive outcomes in terms of the developed fall prevention plan. The existing procedures were scrutinized and carefully evaluated by the workflow at the hospital (Penna, 2015). One of the most important factors that impacted the first stage of the implementation plan was the absence of a fall prevention plan. The next stage contained the development of a specific strategy intended to help the patients learn more about the dangers of falls and other related hospital hazards.
The patients were told about the implementation of the new fall prevention plan, and the removal of health illiteracy within the framework of the developed fall prevention plan was rather important for the current project because it minimized the influence of the human factor on the outcomes of the implementation of the new fall prevention plan. Then, a group of health care professionals brought together a special committee that was intended to evaluate the new fall prevention plan (Sare & Ogilvie, 2016). The committee secured the implementation of the plan and guided the deployment of the fall prevention plan throughout the whole process. The future of the fall prevention plan was also discussed and included certain information regarding the changes that had to be made in the hospital’s workflow (Canning et al., 2014). All the critical ineptitudes were successfully minimized using assembly and productive discussions.
Implementation Plan Elements for Each Activity
At Rashid Hospital, the staff was heavily involved in the process of developing and implementing the new fall prevention plan. The first activity was the measurement of the falls that occurred during the last month. Then, the employees were up to comparing those numbers to the number of falls that occurred at the same time during the last year. After some meetings, it was decided by the team that several actions have to be taken to improve the developed fall prevention plan (Sare & Ogilvie, 2016). Some colorful bracelets were introduced to Rashid Hospital staff that represented the patients that were at risk.
Another element of the implementation plan was the discussion regarding what patients were originally at risk. It was found that the patients with terminal illnesses, heart diseases, and poor eyesight were expected to make the list of the patients who fell the most. After the revision, the team concluded that it was also essential to place several caution signs that would warn the patients about wet floors and other hazards (Thompson, 2015). That element of the plan was included to improve the safety of the staff and the patients that were not members of the risk groups as well. The last element was the assignment of several nurses to a single patient so that they could monitor him throughout the whole 24 hours. This activity was intended to improve interpersonal relations between the nurses and patients and secure the environment at Rashid Hospital.
Relationship between Elements for Each Activity
The relationship between the elements of each activity can be discussed as a relationship between the stages of implementation of the new fall prevention plan. The first activity (the measurement of falls) is contingent on the involvement of the staff and their willingness to improve the quality of care (Canning et al., 2014). Based on the obtained information, the committee decided to expand the measures intended to support patient safety and included additional preventive measures in the plan. The last factor that impacted the relationship between elements for each activity was the rotation of nurses. The efficiency and reasonableness of this decision will be discussed in the last section of this paper, but it can be started right away that nurse rotation significantly affected Rashid Hospital patient satisfaction.
Anticipated Outcomes
Set of Indicators
As it had been proposed, the outcomes of the implementation of the new fall prevention plan were measured using a Balanced Score Card system (Swayne, Duncan, & Ginter, 2013). Three core performance indicators were used to evaluate the efficiency of the novel fall prevention plan:
- Patient satisfaction
- Number of patient falls (in before/ after format)
- Nurse rotation time (meaning how much time a nurse spends with the patient before they leave or close their shift) (Glembocki & Fitzpatrick, 2013).
Indicator Threshold
The thresholds for the indicators mentioned above were set as follows:
- Patient satisfaction
- Satisfied – pass
- Unsatisfied – failure
- Number of patient falls
- Less than in April 2016 – acceptable
- More than in April 2016 – failure
- Nurse rotation time
- Slight overlap or timely rotation – acceptable
- Slow rotation or a disproportionally long shift – failure
Report
Communication
The performance of Rashid Hospital was found to increase in all three indicators. The costs of the project were evaluated as minimal, and the deployment of a new fall prevention plan was identified as obligatory (Hempel et al., 2013). The administration was also interested in developing a long-term plan to mitigate the complications that may transpire throughout the implementation of this fall prevention strategy. The positive impact of the fall prevention plan was also discussed by both the employees and patients. The majority of patients mentioned that they had learned a lot of necessary things regarding their safety. In general, they said that they felt a lot safer when they stayed at Rashid Hospital. The process of reducing the patients’ health illiteracy helped the latter to expand their knowledge base and become a part of an important health care project (Hempel et al., 2013). The nurses, at the same time, claimed that their professional skills were significantly improved by the developed fall prevention plan. The overall mark for patient satisfaction is “pass.”
The number of falls among Rashid Hospital patients was found to be significantly reduced by the novel fall prevention plan (see Figure 1).
Figure 1. Falls among patients in Rashid Hospital during April 2017.
Overall, the nurses stated that it became much easier to monitor patients, and the decision to implement the bracelets of different colors significantly facilitated the process of providing care to the patients. The latter, at the same time, claimed that it became a rather motivating experience, and they did not expect that they would find out so many new things regarding their illnesses or safety measures that had to be met (Canning et al., 2014). Both health care professionals and Rashid Hospital patients specified that the decision to place warning signs all over the hospital was also a useful asset. Finally, the majority of Rashid Hospital patients expressed their satisfaction with the services, and the ultimate decision regarding the fall prevention plan was that it became the key contributor to the reduced number of falls among the patients that had been identified as the members of risk groups (Canning et al., 2014). The final mark for this particular assessment is “acceptable” because the number of patient falls was reduced by 81.25% in comparison to the number of falls that occurred during the same month in 2016.
The nurse rotation time became the most questionable indicator due to miscellaneous results of the assessment. According to the patient survey, the rotation was found to be ineffective and should be reviewed. The majority of nurses, at the same time, supported the opinion that the rotation schedule should be reviewed. Within the current prevention plan, the nurses were supposed to rotate after a 12-hour shift (with a one-hour lunch break). This meant that only two nurses were responsible for a patient within 24 hours. According to the data obtained from the nurses, they were willing rather spend fewer hours observing the patient than work for an extended period (11-12 hours) to be able to concentrate and provide their patient with the best health care services.
The idea behind this was that three nurses were able to manage the patient perfectly (Sare & Ogilvie, 2016). Nonetheless, it was also important to take into consideration the fact that disproportionally long shifts and slow rotation became the main bottlenecks of the existing fall prevention plan and majorly impacted how it was perceived by all the partakers of the research project. The ultimate mark for this particular part of the fall prevention plan is “failure,” but the adverse outcomes of an ineffective rotation schedule were related mainly to the nurses at Rashid Hospital and not the patients. The ultimate results and feedback signal that an efficiently developed fall prevention plan has mainly positive influence on the health care facility and its presence in the hospital environment should be considered indubitable.
References
Canning, C. G., Sherrington, C., Lord, S. R., Close, J. C., Heritier, S., Heller, G. Z.,… Fung, V. S. (2014). Exercise for falls prevention in Parkinson disease: A randomized controlled trial. Neurology, 84(3), 304-312. Web.
Glembocki, M. M., & Fitzpatrick, J. J. (2013). Advancing professional nursing practice: Relationship-based care and the ANA standards of professional nursing practice. Minneapolis, MN: Creative Health Care Management.
Hempel, S., Newberry, S., Wang, Z., Booth, M., Shanman, R., Johnsen, B.,… Ganz, D. A. (2013). Hospital fall prevention: A systematic review of implementation, components, adherence, and effectiveness. Journal of the American Geriatrics Society, 61(4), 483-494. Web.
Penna, M. (2015). Medical staff integration: Transactions and transformation. Boca Raton, FL: Taylor & Francis.
Penner, S. (2013). Economics and financial management for nurses and nurse leaders. New York, NY: Springer.
Persily, C. (2013). Team leadership and partnering in nursing and health care. New York, NY: Springer.
Sare, M. V., & Ogilvie, L. (2016). Strategic planning for nurses: Change management in health care. Sudbury, MA: Jones and Bartlett.
Swayne, L. E., Duncan, W. J., & Ginter, P. M. (2013). Strategic management of health care organizations. Malden, MA: Blackwell Publishing.
Thompson, C. (2015). Prevention practice and health promotion: A health care professional’s guide to health, fitness, and wellness. Thorofare, NJ: Slack Incorporated.
Yoder-Wise, P. S. (2013). Leading and managing in nursing. St. Louis, MO: Mosby Elsevier.