Idea Transcript
Running head: ORIENTATION PROPOSAL
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Management Orientation Proposal Stacey Magee American Sentinel University
ORIENTATION PROPOSAL
2 Management Orientation Proposal
The purpose of this paper is to propose an orientation program format for the hospice program supervisors and managers. The format chosen will provide a self-directed orientation and serve as an ongoing reference tool. This program will enhance the current orientation process which lacks structure and self-direction. Nurses deserve a purposeful, meaningful orientation that is specific to their specialty (Sims & Bodnar, 2012). At UC Davis we worked collaboratively to develop shared nursing core competencies that are included in hospital orientation but then the expectation is to have nursing orientation be department specific for ambulatory nursing and home care. Nursing orientation should include essential and related information about quality care, safety, infection control, ethics, assessments, emergency response, regulatory, licensing and accreditation information, policies, and procedures and shared governance (Sims & Bodnar, 2012). Health care is constantly changing and an effective orientation program must provide learners with current information and tools related to their specialty (Sims & Bodnar, 2012). Topic Directs and supervises clinical staff
Rationale for Inclusion Objectives Nurse leaders need to be 1. Nurse leader will be able to able to create, share a demonstrate understanding of vision, set an example developing an effective plan of care and resolve conflict and monitoring and evaluating (Moss, 2005). patient care outcomes. 2. Nurse leader will be able to support staff’s ability to meet required performance and competency standards
Resources Hospice policy: 751.5 Supervision http://www.hr.ucdavis.edu/sdps/onb oarding-toolkit-supervisorsguide/first-week/first-weekorientation
ORIENTATION PROPOSAL Topic Primary resource and mentor to new nurses
Staffing and scheduling
Nursing evaluations 1. Probationary period 2. Performance Management 3. Employee Recognition Hospice referral coordination
Hospice contract services 1. Pharmacy 2. Transportation 3. DME 4. Supplies
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Rationale for Inclusion Objectives Nurse leaders need to be 1. Nurse leader will be able to support able to create, share a staff’s ability to meet required vision, set an example performance and competency and resolve conflict standards (Moss, 2005). Staffing a hospice program should be based on characteristics of the patient served, environmental considerations and staff competence (NHPCO, 2013) Employee evaluations are an opportunity for a manager to identify good practice and opportunities for improvement (Stonehouse, 2013) Orientation should be specific to the nurse’s specialty (Sims & Bodnar, 2012) Orientation should be specific to the nurse’s specialty (Sims & Bodnar, 2012)
1. Nurse leader will develop schedules to meet patient care need and nursing productivity standards 2. Nurse leader will be able to create and oversee a fair staff schedule based on staffing, patient care needs, acuity and competency of staff. 1. Nurse leader will complete annual evaluations for direct reports. 2. Nurse leader will provide feedback to indirect reports annually. 3. Nurse leader will utilize employee recognition program. 1. Nurse leader will be able to coordinate referrals taking into consideration hospice admission criteria and goals of care 1. Services provided based on formulary or interdisciplinary team process 2. Medication cost meets budgeted expense 3. Other contract services meets budgeted expense.
Resources Hospice policy: 751.7 Requirements for Supervisors/Preceptors http://www.hr.ucdavis.edu/sdps/onb oarding-toolkit-supervisors-guide Hospice Policy: 751.1 Hospice Personnel Plan/Staffing http://www.nhpco.org/sites/default/ files/public/quality/Staffing_Guidel ines.pdf
Hospice policy: 754.1 Performance Evaluations http://www.hr.ucdavis.edu/sdps/onb oarding-toolkit-supervisorsguide/first-year/first-yearperformance-management http://www.nhpco.org/hospiceeligibility-requirements
http://www.nhpco.org/regulatory/bi lling-and-reimbursement
ORIENTATION PROPOSAL
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Topic Hospice insurance and reimbursement 1. Medicare/Medicaid 2. Private Insurance 3. Donated Funds Hospice external regulations 1. Medicare Conditions of Participation (CoP) 2. Hospice State Standards 3. The Joint Commission 4. HIPAA
Rationale for Inclusion Objectives Orientation should be 1. Program will be reimbursed for care specific to the nurse’s provided. specialty (Sims & 2. Bad debt will meet or exceed budget Bodnar, 2012)
Resources http://www.nhpco.org/regulatory/bi lling-and-reimbursement
1. Program meets Medicare CoP’s, Joint Commission standards and state licensing standards. 2. Programs maintains hospice license by the state and federal government. 3. Program maintains accreditation by Joint Commission. 4. Nurse leader ensures HIPAA compliance is maintained.
http://www.nhpco.org/regulatory/bi lling-and-reimbursement
Information Systems: Electronic Medical Record
Technology supports point of care assessment and care planning along with available resources (Tapper, et al, 2012) Human relations is ranked one of the most important characteristics of a nurse manager (Dienemann & Shaffer, 1993)
Human Resources 1. Leave/time off 2. Holidays 3. Violence in the work place 4. Sexual harassment
Orientation should be specific to the nurse’s specialty (Sims & Bodnar, 2012)
1. Documentation will reflect patient status and patient care provided 2. Documentation will meet regulatory requirements 1. Nurse leader will demonstrates ability to manage scheduling and time off requests while meeting departmental needs. 2. Nurse leader will demonstrates awareness of appropriate work place behavior. 3. Nurse leader will ensure employees are current with annual mandatory violence in the work place and sexual harassment training.
https://www.cms.gov/Center/Provid er-Type/Hospice-Center.html http://www.cms.gov/Regulationsand-Guidance/HIPAAAdministrativeSimplification/HIPAAGenInfo/inde x.html http://www.ucdmc.ucdavis.edu/him / http://intranet.ucdmc.ucdavis.edu/e mr/ Hospice policy: 755.1a. Use of Paid Time Off http://www.hr.ucdavis.edu/employe e/leave-time-off http://www.hr.ucdavis.edu/supervis or/Er/Violence http://shep.ucdavis.edu/
ORIENTATION PROPOSAL Topic Performance Improvement 1. Lean Six Sigma 2. DMAIC 3. PDSA 4. QAPI
Hospice specialty services 1. We Honor Veterans 1. Pediatrics 2. Volunteer 3. Bereavement
Infection Prevention and Control
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Rationale for Inclusion Objectives Quality improvement 1. Nurse leader will complete one initiatives can result in performance improvement project improved care for the each year utilizing an approved dying (D'Onofrio, format. 2001). 2. Patient and programmatic outcomes will meet or exceed departmental goals. 3. Patient and programmatic outcomes will be benchmarked with state and national outcomes. Orientation should be 1. Nurse leader will assist with specific to the nurse’s obtaining level 3 We Honor specialty (Sims & Veteran’s status by 2015 Bodnar, 2012) 2. Nurse leader will ensure program meets program goals specific to services provided
Infection prevention in the home includes hand washing, environmental cleanliness, isolation precautions and use of protective equipment (Jeanes & Swanson, 2013)
1. Infections will be tracked, trended and reported annually. 2. Catheter associated urinary tract infections (CAUTI) and central line associated blood stream infections (CLABSI) will be reported separately.
Resources http://intranet.ucdmc.ucdavis.edu/cl inops/resources/performance_impro vement.shtml http://intranet.ucdmc.ucdavis.edu/cl inops/data/performance_improveme nt/DMAIC_and_PDSA_2011.pdf http://www.nhpco.org/quality http://www.wehonorveterans.org/ http://www.nhpco.org/resources/pe diatric-hospice-and-palliative-care http://www.nhpco.org/education/vo lunteer-and-volunteer-management http://www.nhpco.org/resources/gri ef-and-bereavement Hospice policy: 850.1 Infection Control and Prevention Plan http://www.cdc.gov/
ORIENTATION PROPOSAL
6 Conclusion
Nurses require an orientation and competency program specific to their specialty in order to be successful. Nursing leaders similarly require an orientation program specific to their specialty, supervision and management. With this new tool, UC Davis Home Care will be able to provide a self-directed orientation program and provide supervisors with a reference tool for continued success.
ORIENTATION PROPOSAL
7 References
Centers for Disease Control and Prevention. (n.d.). www.cdc.gov Centers for Medicare and Medicaid Services. (n.d.). http://www.cms.gov/ Dienemann J, Shaffer C. (1993). Nurse manager characteristics and skills: curriculum implications. Nursingconnections. Summer;6(2):15-23. D'Onofrio, C. (2001). Hospice quality improvement programs: an initial examination. Journal Of Nursing Care Quality, 15(4), 29-47. Health Insurance Portability and Accountability Act, Title II U.S. Department of Health & Human Services § (1996). Jeanes, A., & Swanson, J. (2013). Simple and consistent infection prevention. Nursing & Residential Care, 15(10), 646. Moss, M. (2005). The Emotionally Intelligent Nurse Leader. San Francisco, CA: AHA Press. National Hospice and Palliative Care Organization. (n.d.). www.nhpco.org National Hospice and Palliative Care Organization. (2013). Staffing guidelines for hospice home care teams. Retrieved from www.nhpco.org/staffing-guidelines Sims, M., & Bodnar, G. (2012). Adding value to nursing orientation for ambulatory care nurses. AAACN Viewpoint, 34(4), 4-7. Stonehouse, D. (2013). Appraisal: a key tool to delivering quality care. British Journal Of Healthcare Management, 19(7), 338-341. Tapper, L., Quinn, H., Kerry, J., & Brown, K. (2012). Introducing handheld computers into home care. Canadian Nurse, 108(1), 2832. The Joint Commission. (n.d.). http://www.jointcommission.org
ORIENTATION PROPOSAL
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UC Davis Center for the Professional Practice of Nursing. (n.d.). http://www.ucdmc.ucdavis.edu/cppn/professional_connections/emerging_nurse_leaders.html UC Davis Health System Finance. (n.d.). http://intranet.ucdmc.ucdavis.edu/finance/ UC Davis Health System Human Resources (2012). Supervisors tool kit. http://www.ucdmc.ucdavis.edu/hr UC Davis Health System Health Information Management. (n.d.). http://www.ucdmc.ucdavis.edu/him UC Davis Health System Infection Prevention. (n.d.). http://intranet.ucdmc.ucdavis.edu/infectioncontrol/ UC Davis Home Care. (2009). 751.7 Requirements for supervisors and preceptors [policy]. Sacramento, CA: UC Davis Home Care. UC Davis Home Care. (2009). 751.1 Performance evaluation [policy]. Sacramento, CA: UC Davis Home Care. UC Davis Home Care. (2009). 850.1 Infection control and prevention plan [policy]. Sacramento, CA: UC Davis Home Care. UC Davis Home Care. (2009). 755.1a. Use of paid time off [policy]. Sacramento, CA: UC Davis Home Care. UC Davis Home Care. (2009). 755.5 Supervision [policy]. Sacramento, CA: UC Davis Home Care. We Honor Veterans. (n.d.). http://www.wehonorveterans.org/ World Health Organization. (n.d.). http://www.who.int/en/