Care Setting Environmental Analysis

Care Setting Environmental Analysis

Write a 4-7 page analysis (not including title or reference pages) of your care setting that supports development of a strategic plan and includes both the discovery and dream phases of an appreciative inquiry (AI) project and a strengths, weaknesses, opportunities, and threats (SWOT) analysis of care setting. Cite at least 3-5 sources of scholarly or professional evidence to support assertions. Must have a title page and reference page no abstract.Care Setting Environmental Analysis

Part 1: Appreciative Inquiry Discovery and Dream

• Synthesize stories and evidence about times when a care setting performed at its best with regard to quality and safety goals.
  • Collect stories from your care setting. You may collect stories through interviews or conversations with colleagues or provide your own.
  • Explain how your stories are related to quality and safety goals.
  • Describe the evidence you have that substantiates your stories.
  • Identify the positive themes reflected in your stories.
  • Describe other evidence (for example: data, awards, accreditations) that validates your care setting’s positive core.
• Propose positive, yet attainable, quality and safety improvement goals for your care setting.
  • Explain how accomplishing these goals will lead to ethical and culturally-sensitive improvements in quality and safety.
  • Explain how your proposed goals align with your care setting’s mission, vision, and values.

Part 2: SWOT Analysis

• Conduct a SWOT analysis of your care setting, with respect to quality and safety goals.
  • Provide a narrative description of your analysis.
  • Identify the assessment tool you used as the basis of your analysis. Care Setting Environmental Analysis
  • Describe your key findings and their relationships to quality and safety goals.
• Describe one area of concern that you identified in your SWOT analysis—relevant to your care setting’s mission, vision, and values—for which you would propose pursuing improvements.
  • Explain how this area of concern relates to your care setting’s mission, vision, and values.
  • Explain why you believe it will be necessary and valuable to pursue improvements related to this area of concern.

Part 3: Comparison of Approaches

Compare the AI and SWOT approaches to analysis and reflect on the results.

• Describe your mindset when examining your care setting from an AI perspective and from a SWOT perspective.
• Describe the types of data and evidence you searched for when taking an AI approach and a SWOT approach.
• Describe the similarities and differences between the two approaches when communicating and interacting with colleagues.

Part 4: Analysis of Relevant Leadership Characteristics and Skills

Analyze the leadership characteristics and skills most desired in the person leading potential performance improvement projects, taking both an AI and SWOT approach.

• Explain how these characteristics and skills would help a leader facilitate a successful AI-based project and a successful SWOT-based project.
• Comment on any shared characteristics or skills you identified as helpful for both AI and SWOT approaches.

Analysis of a Care Setting for Strategic Planning Purposes: Contrasting the Appreciative Inquiry (AI) and the SWOT Analysis Approaches Care Setting Environmental Analysis

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Part 1: Appreciative Inquiry Discovery and Dream

The appreciative inquiry model is an organizational assessment method developed by David Cooperrider that focuses on positive developments within the organization as opposed to what is wrong. It takes attention away from the pessimistic problem-solving and deficit thinking approach so often adopted by many healthcare industry executives and leaders. Rather, it focuses on supportive and more optimistic behaviors within the healthcare organization. With AI, attention is shifted to an appreciative inquiry of the positive stories within the healthcare organization. Creative genius, a sense of togetherness, and pride then emerge as a result of this. A whole new view of the organization and infinite possibilities become apparent, enabling the future to be built based on past successes within the care setting. AI, therefore, adopts a positive appreciation of individual and collective efforts within the care setting, emphasizing what is right and what is working in the care setting. It then endeavors to do more of that which has worked in the past. Appreciative inquiry comprises of five phases or steps, the first of which is the selection of an affirmative topic around which the other four rotate. These other four stages are discovery, dream, design, and destiny (Stevenson, 2019). One main application of the appreciative inquiry model is in strategic planning, as in this case. The analysis of this particular care setting focuses on the discovery and dream phases.

Discovery

In analysis using AI, the phase of discovery involves the collection of data and exploration of positive narratives within the organization. The aim is to explore success stories shared by interviewing persons of interest within the organization. Discovery during AI, therefore, unearths positive experiences of persons in the organization, with a view to replicating the same for future success (Stevenson, 2019). In this case, stories were collected using interviews done after identifying the stakeholders to be interviewed and developing the questionnaire. Two particular stories in this care setting stood out for their positivity – one from a nurse manager and the other from a registered nurse clinical nurse leader.Care Setting Environmental Analysis

The nurse manager narrated how she was able to bring a physician who had belittled one of her unit nurses to apologise to the victim for telling her that she did not use her brain. The incident had occurred in the presence of patients and the physician’s unfortunate remarks had been provoked by the nurse’s forgetfulness in informing him that the patient had declined exploratory laparoscopy. When the offended nurse reported this to the nurse manager, she says that she knew that the physician’s utterances were not good for the psychological safety of the workplace. She, therefore, felt that she needed to do something to stop that from happening in the future. She then approached the physician and made him apologize formally to the nurse. The registered nurse on her part narrated how she was able to forestall a potentially explosive workplace violence scenario involving the relative of a patient and a junior nurse in her team during an afternoon shift. The relative felt that his patient was being neglected and sought to vent his anger on the junior nurse. Being the clinical nurse leader on the shift, the registered nurse was able to identify the signs of the impending physical violence and call the relative aside to cool him down. She was happy that this was due to her training on conflict resolution, and that her actions preserved the psychological safety of the workplace and hence patient safety. It was a win-win situation because the junior nurse felt appreciated and the patient’s relative also felt satisfied.

These stories are related to safety and quality in that a nurse who is threatened and stressed out by feeling belittled and unwanted is prone to making errors. This puts patient safety at risk and lowers the quality of nursing care delivered as the nurse is not able to concentrate fully on her tasks. The evidence that substantiates these stories is found in the entries on the specific dates of these two occurrences in the incidents book. The positive themes reflected in these two stories are that healthcare work environments can be made conducive, and transformational leadership in nursing is important for the delivery of quality nursing care and the assurance of patient safety. The other evidence that validates my care setting’s positive core is that every year in my organization, there is a handsome award for the best nurse manager and the best nurse overall of the year. In the two stories above, the registered clinical nurse leader was able to receive the award for the best nurse overall that year for her role in defusing the tension that could have resulted in physical workplace violence. This is a good incentive that rewards effort and initiative and hence encourages a repeat and replication of such good actions.Care Setting Environmental Analysis

Dream

            The dream phase is the stage that starts the process of what could be. It involves the thinking of possibilities beyond today’s thinking. The interviews conducted in the discovery phase have yielded the above two stories of success within the care setting. Therefore, if these stories are embedded in the organization culture, they will definitely direct future success of the organization (Stevenson, 2019). The dream proposals of positive and attainable quality and safety improvement goals for this care setting are to empower the nurses to feel free to report any threats to them either physical or psychological, to put in leadership positions only nurse leaders who have demonstrated exemplary transformational leadership, and to always adopt a consultative approach when making any procedural changes in the care setting by seeking the opinions of the nurses. Accomplishing these goals will lead to ethical and culturally sensitive improvements in quality and safety in that a nurse who feels safe in the workplace will respect the patient’s wishes (autonomy), will care for the patient with dedication (beneficence), and will not commit errors that put the patient at risk (nonmaleficence). Autonomy, beneficence, and nonmaleficence are all important bioethical principles. The nurse will also wholeheartedly care for the patient holistically, which means that they will also respect the cultural beliefs and practices of the patient. Lastly, the proposed goals will align with the care setting’s mission, vision, and values in that the mission is to provide the best possible nursing care while the vision is to be the leading care setting in the country in terms of quality and safe nursing care. The values of the care setting include integrity, fairness, honesty, and justice. Having transformational nurse leaders and allowing nurses to freely air their grievances is both fair and just.

Part 2: SWOT Analysis

SWOT analysis in the organizational context stands for strengths, weaknesses, opportunities, and threats. Strengths and weaknesses are usually internal to the organization, while opportunities and threats are traditionally external. This analysis will therefore look at the care settings internal strengths and weaknesses, the opportunities available for it to grow and improve, and the threats to its survival from the external environment (Gretzky, n.d.). Generally, a SWOT analysis comes before strategic planning. In this case, a SWOT analysis of this care setting was conducted, with regard to quality and safety goals.

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            Strengths enable the organization to demonstrate outstanding organizational performance (Gretzky, n.d.). The strengths of this healthcare setting after data collection and analysis are having of a dedicated nursing staff that is very hardworking and committed, having an in-house upskilling program for the staff to make them more proficient and safe, possessing the latest state-of-the-art healthcare technologies for improved quality of care, adoption of healthcare informatics and the recruitment of a nurse informaticist, and the use of telehealth services to reach a  number of patients who are in remote areas.

The opportunities identified for this care setting were that there is a growing population of middle-class people around its location who can become part of its catchment area (assuring a steadier stream of revenue to be used for care and quality improvement), an opportunity for social media marketing (which will inspire the care setting to improve the quality of its services in view the anticipated surge in numbers), and rapid advances in smartphone telephony (which means that much more patients can now be reached remotely through their smartphones on the telehealth platform).Care Setting Environmental Analysis

Weaknesses in a healthcare organization typically lower quality of care and increase costs (Gretzky, n.d.). In this care setting, the weaknesses identified were a high staff turnover which is affecting the safety of patients and quality of care given, a large number of the workforce requiring upskilling to have the right skill mix, and finite financial resources for the professional development of staff. This impacts the quality of care rendered and threatens the safety of the patients.

Threats interfere with the performance of the organization (Gretzky, n.d.). In the case of this care setting, the threats demonstrated were increased competition for patients from new entrants, a reduction of Medicare reimbursement, and restricted practice by the state for nurse practitioners (NPs). Restricted practice means that she cannot make certain clinical decisions until she consults the physician in a collaborative agreement with her.

The assessment tool used in this analysis was the SWOT analysis. The key findings were that there is an inordinately large number of nurses leaving work. This affects the nurse-patient ratios and therefore the quality of care given. Another issue was that many of the nurses and other staff require upskilling to bring their skills up to date. This fact alone threatens the safety of the patient as the person taking care of them may not be familiar with the gadgets they are using.

An Area of Concern

One area of concern that I identified during the SWOT analysis and relevant to the care setting’s mission, vision, and values is the fact that the NPs at the care setting are under restricted practice. This means that they are not able to do some things and offer some services despite the fact that they are qualified and educated to do exactly that. This area of concern relates to my care setting’s vision, mission, and values in that an NP that can provide the full range of services that they are trained to deliver will provide quality care at a cost that is affordable compared to a physician. This makes the services cost-effective and hence desirable. Services like these will not only be fair, but also just. It will be necessary and valuable to pursue improvements in this area of concern because majority of clinicians in the care setting are nurse practitioners and it is them who are tasked with providing primary health care to the greater majority of the patients seen at the care setting. Because of this, it would be valuable and quite necessary to pursue improvements in the scope of practice for the NPs.Care Setting Environmental Analysis

Part 3: Comparison of Approaches

The AI approach to analysis is very different from the SWOT approach. It basically adopts a positive outlook to the process while the SWOT model adopts a pessimistic outlook. My mindset when using the AI approach is to expect positive feedback. When using the SWOT paradigm, it expects to find fault. The types of data and evidence I expect to find with AI are anecdotes and snippets of stories and initiatives that were successful in the past. The types of data I expect with the SWOT approach are facts and figures. The similarities between the two are that they are both aimed at making the organization function better, and both are also designed to help with strategic planning. The main difference between the two is that one looks for positive feedback while the other concentrates on negative feedback.

Part 4: Analysis of Relevant Leadership Characteristics and Skills

The leadership characteristics and skills desired in AI include communication skills, empathy, humility, vision, and positivity. In SWOT they are communication, integrity, accountability, and delegation (Enfroy, 2020). These characteristics would help them facilitate a project in that the AI person will be likeable and approachable while the SWOT person will be required to present only facts and uphold integrity. The only obvious shared characteristic between the two is the fact that both need to have effective and efficient communication skills. This may be because they both need to communicate properly and effectively with their teams. Care Setting Environmental Analysis

 

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