Introduction
The recent practicum experiences in a walk-in urgent care center serving both pediatric and adult populations have created new insights linked to staffing and patient teaching materials’ availability. These takeaways greatly inform the initially proposed change that consists of improving the facility’s follow-up call system by addressing barriers to patient reachability and contact data accuracy. This assignment details the relevant insights and explores their implications for personal leadership progression, change planning, and relevant supports to further the project.
New Insights Gained Through Practicum Experiences
The Urgent Care Setting’s Process Improvement Potential and Staffing Levels
Experiencing minor understaffing, the practicum site, as evidenced by the recent increase in patient referrals linked with injuries from falls and respiratory tract/uncomplicated urinary tract infections, might be imperfectly prepared to initiate adequate post-discharge communication. The care setting’s current follow-up communication system relies on non-automated calls that the nursing staff performs with the focus on more severe clinical cases. Nevertheless, the initial failures to contact clients, including non-answered calls and incorrect contact details, are not uncommon. Combined with minor staff shortages, such factors can cause imbalances in the facility’s internal activity structure while also affecting post-discharge subsequent healthcare referrals by influencing the proportion of cases in which post-discharge self-care and referral instructions have been followed (Joo et al., 2019). The urgent care center’s multi-component post-discharge information system can, therefore, be imperfectly effective considering the current overall nursing workload.
Available Materials and Urgent Care Patients’ Misunderstanding of Nurse-Initiated
Follow-up Communication
Another crucial insight pertains to the patient awareness promotion aspect of the practicum site’s follow-up care system, especially the lack of materials to simplify patient contact information verification and prevent non-working numbers’ entry. Based on quality improvement research, more than 15% of post-discharge contacting attempts fail due to healthcare consumers’ limited reachability and wrong numbers, which deals with both data collection systems’ deficiencies and the lack of patient awareness interventions (Felipe et al., 2021). The practicum site’s awareness-building endeavors pertaining to follow-up calls are limited by the mandatory completion of patient information forms that provide spaces for telephone number/physical address information. Document design solutions to emphasize the phone number’s role, efforts to encourage patients to double-check their information, extra fields for additional details, such as work/personal phone numbers, hours available, or alternative preferred contact methods, are virtually absent. Addressing these deficiencies in the final implementation plan will be a crucial priority.
New Insights’ Impact on Practicum Experiences
Leadership Progression
To be resolved, the multi-dimensional contributors to the follow-up call issue, including the nursing workload, patients’ uncooperativeness, limited awareness, and no information rechecking reminders targeted at clients, would require new leadership competencies. The prerequisites for success as a clinical nurse leader include leader-staff motivational communication, group discussion organization, and giving consideration to negative feedback (Heinen et al., 2019). My leadership development, therefore, should center the ability to serve as a link between the nursing staff, IT specialists, and the management and make the need for process improvement recognized and discussed collectively to produce a win-win solution for all involved parties.
Change Planning
The takeaways introduce adjustments to the plan for change by adding new promising process improvement methods to increase the follow-up system’s effectiveness. Specifically, the identified lack of follow-up-related education makes patient teaching posters, a common awareness-raising measure, a viable component of the planned change strategy (Chan et al., 2021). Wall posters in the waiting room to highlight service consumers’ adequate participation in post-discharge communication as a health improvement measure can become a cost-effective awareness-raising intervention. Similarly, barriers to contact information’s correctness may create the need to evaluate and redesign patient information forms as part of the project (Cummins et al., 2018). Some changes for collective evaluation include placing the telephone number area under the name area to emphasize it, font size/color changes to highlight the contact number field, and subfields for patient-reported optimal time for follow-up calls. Finally, considering the workload-related trends, planning efforts to evaluate the feasibility of semi-automated post-discharge telephone interview processes with the use of text-to-speech software could be essential.
Additional Supports
The ongoing practicum site research, leadership, and change planning efforts would benefit from supports linked with access to timely professional advice. In its current form, the planned change proposal partially exceeds the nursing staff’s area of expertise and requires other qualified specialists’ inputs linked with mass communication graphic design and IT tools for semi-automated data collection. Any mistakes leading to patient information losses or improperly recorded post-discharge needs and questions would be costly for the facility’s reputation and integrity, which is why automation-related process improvement ideas’ practical relevance will require the most diligent possible analysis (Cummins et al., 2018). Moreover, budget impact analysis for each proposed follow-up process improvement should inform the final decision, so ongoing informational support from the facility’s finance department would be essential. The aforementioned leadership competency development plans are anticipated to instrumentalize these essential supports and ensure each selected intervention’s feasibility in a timely manner.
Conclusion
To sum up, the takeaways heavily impact the ongoing practicum experience. Regarding the latter’s leadership progression dimension, the new insights call for developing a more profound understanding of coordinating inter-professional teams’ communication. Influences on planning, including increases in the range of process improvement ideas for evaluation, are also evident. The ideas’ increasing complexity in terms of the required skills makes the necessary supports centered on subject matter experts’ assistance.
References
Chan, F., Lai, S., Pieterman, M., Richardson, L., Singh, A., Peters, J., Toy, A., Piccininni, C., Rouault, T., Wong, K., Quong, J. K., Wakabayashi, A. T., & Pawelec-Brzychczy, A. (2021). Performance of a new symptom checker in patient triage: Canadian cohort study. Plos One, 16(12), 1-11.
Cummins, M. R., Ranade-Kharkar, P., Johansen, C., Bennett, H., Gabriel, S., Crouch, B. I., Del Fiol, G., & Hoffman, M. (2018). Simple workflow changes enable effective patient identity matching in poison control. Applied Clinical Informatics, 9(3), 553-557.
Felipe, A., Vats, A., Sleiman, A., Tran, B., Akel, M., Chia, O., Hester, J. M., Hoh, D. J., Busl, K. M., & Baron-Lee, J. (2021). Using intern-led quality improvement to reduce readmissions for specialty service patients within an academic medical center. Global Journal on Quality and Safety in Healthcare, 4(2), 70-76.
Heinen, M., van Oostveen, C., Peters, J., Vermeulen, H., & Huis, A. (2019). An integrative review of leadership competencies and attributes in advanced nursing practice.Journal of Advanced Nursing, 75(11), 2378-2392.
Joo, K. R., Brewer, T. L., & Matcham, W. A. (2019). Implementation of text message reminder system in the pediatric urgent care to improve compliance with asthma care follow-up.Journal of Informatics Nursing, 4(1), 612.