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Strategic Leadership and Future Delivery Models

Application of Strategic Leadership and Future Delivery Models

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Section D: how organizational change can help improve the chosen hospital’s HCAHPS scores

Organizational change is vital to the enhancement of scores on the Hospitals Consumer Assessment of Healthcare Providers and Systems (HCAHPS). Palmetto Health Richland needs to check on the change of the organization culture and its perspectives towards the patients so that the current level of HCAHPS scores can improve to a more satisfactory level. One of the aspects of Palmetto Health Richland, that’s need to be changed is the communication between the hospitals staffs and the patients.

Healthcare experts in this hospitals should be communicating clearly and more often to the patients. In their discussions with the patients, the workers should listen to them; explain to them why they should take medicine as prescribed in a polite way as well as elucidating the side effects of the medication that they give to their patients (Berrett & Spiegelman, 2013). This can be achieved if the nurses and doctors in this hospital could be writing instructions and the explaining them to their patients verbally and then allowing the patients sometimes to respond to their questions. More so, communication in this hospital can be reinforced through follow-up calls that the healthcare professionals ought to make to their patients after they leave the hospital. Follow up calls are significant because they provides the doctors and nurses with an opportunity to answer questions from their patients, remind them on following the medication instructions and also receiving feedback from their patients on the effectiveness of their services.

Another strategy that organizational change in Palmetto Health Richland can adopt is the collection of information from the patients and acting on it. Receiving feedback from the patients and assessing their satisfaction provides critical information that can help Palmetto Health Richland to improve HCAHPS scores (Studer, Robinson & Cook, 2010). The information obtained is crucial since it provides the hospital with an opportunity to identify problems within the institution, and it can work on towards rectifying them. This way, the management at the hospital will be able to recognize changes that are relevant to the patients and which will eventually drive the most valuable improvement on HCAHPS scores.

Educating patients is another strategy that is of paramount importance in Palmetto Health Richland hospital. The hospitals need to come up with strategies that will ensure that patients who are come in this hospital are educated from the time they are admitted to the time they are released. This can either be done through one-to-one interactions with medical staffs or it can be done be videos on the patients bedsides or even written instructions (Studer, Robinson, & Cook, 2010). This increases patients’ satisfaction because they understand more about themselves, and they are able to take care of their health conditions in future. (Rodak, September 4, 2012)

How incorporating evidence-based practice and shared governance can improve organizational quality

As the patient's needs and preferences keeps changing, there is need for Palmetto Health Richland hospital to keep up with the pace by improving the quality of the services offered by the health care institution so that they meet the patients needs and expectations. Shared governance is one tool that can be of great help in taking the quality of services offered to the patients at a higher level. Implementing shared governance in this hospital will enable nurses to work in collaboration with other healthcare workers and leaders allowing them an opportunity of contributing to decision-making (Anthony, 2004). Due to their participation in decision-making, the nurses will willingly control and implement their practices based on the set goals to better for the betterment of the outcome. This will improve the quality of patient care as well as the outcome of the health care institution in general.

The evidence-based practice also has its role in the enhancement of patient care and quality of Palmetto Health Richland hospital. Conducting all nursing practices and processes in line with the published research is the key aspect for the nurses to keep updated with the changes in the field of healthcare that will eventually improve the quality of patients care within the institution (Stevens, 2013). More so, the ability of the nurses in Palmetto Health Richland hospital to obtain information from the patients, to analyze it and to put it into actions by developing strategies to solve the identified problems can take the quality of services at Palmetto Health Richland hospital to a higher level. Methods that can be used to incorporate concepts of shared accountability for patients, medical providers, payers and personnel

Shared accountability in a healthcare institution helps in providing better healthcare services to the patients; improve the healthcare of the entire community and also to lower the cost of management of the health care institution. At Palmetto Health Richland hospital, shared accountability can be achieved through:

i. Engaging patients in provision of better healthcare services in the entire community

The interaction of patients and the medical staffs should cover all aspects of health that comprise mental health, physical health, lifestyle and emotional health (Zimmerli, 2013). Involving patients in the provision of better healthcare services will educate them about their health, prevention measures and the right decisions regarding their healthcare. It also helps patient to comprehend the benefits, relative risks and costs of different treatment options.

ii. Using evidence-based medicine and treatment procedures

Using approved medicine and treatment procedures is an important shared accountability aspect that ensures that the patients receive the treatment care and services that are helpful and which meet their needs and expectations. Also, evidence-based healthcare guides the healthcare providers in providing consistently right treatment services, at the right time and in the right place (Zimmerli, 2013). The healthcare institution will, therefore, minimize medical errors, under treatment, as well as overtreatment cases.

Methods that can be used to incorporate technology trends within healthcare

Technology is taking the field of medicine to higher levels of provision of healthcare services. One approach in which technology can be incorporated in Palmetto Health Richland hospital is by hiring more professionals with the expertise in current technology in medicine such as robotic prostatectomy, radical prostatectomy, radiation therapy, proton beam therapy and intensity –modulated radiation therapy (Zimmerli, 2013). Sometimes it becomes very difficult to implement current technology in a healthcare institution if the health care facility does not have sufficient medical experts to handle the technological devices. The management at Palmetto Health Richland hospital needs to hire more medical staffs with proficiency in current medical technology so that it can be able to embrace the technology in treatment.

Employing the current underlying technology at Palmetto Health Richland hospital such as Electronic Healthcare Records (EHR) and Computerized Physician/Provider Order Entry (CPOE) will also be a better way of introducing modern medical technology into the healthcare institution (Huston, 2013). EHR will allow the healthcare providers to have access to the patients’ health information from multiple healthcare providers anytime the information is needed. CPOE will help the organization to lower its costs of operation of Palmetto Health Richland hospital. It will also increase interventions, minimize medical based on best practices and evidence. Due to the benefits achieved by embracing this fundamental medical technology the management of Palmetto Health Richland hospital will be motivated in embracing even higher technologies and most recent. Methods that can be used to improve the care delivery system, including the topics of quality, cost, access, and patient-centered care

Quality healthcare services should be delivered to patients at the lowest prices possible. At Palmetto Health Richland hospital, this can be achieved by rewarding quality of work done by medical professionals instead of quality, avoiding costly mistakes by adopting the appropriate medical technologies and creating healthy information technology infrastructure that lowers the costs for taxpayers, patients and makes it possible for the for new payments and delivery systems to work as intended. One method that is key to the delivery systems in health care institutions is

i. Comparative Effectiveness Research (CER)

CER is crucial because it focuses on the whole healthcare system in broad terms by comparing the risks, costs of different health care practices and benefits accrued from various operations of a healthcare system (Brennan et.al, 2009) . At Palmetto Health Richland hospital, CER can be implemented by examining and assessing the laws and policies that govern healthcare in this institution to make them better, effective and less costly. It can go a step further and come up with strategies that can be used in handling different groups of patients so that the medical services offered can meet their needs and expectations.

ii. Introduction of care management programs to particular groups of patients

This method of enhancing healthcare delivery system will be adequate for instance in management of patients with multiple chronic health conditions and who need special attention for different specialists (Brennan et.al, 2009). Such a program will work hand in hand with electronic medical records (EMR) and more comprehensive decision supports for both the provider and the patient. Such steps of improving the delivery system will play a crucial role in ensuring patients satisfaction and reduced costs of health care.

Methods that can be used to improve financial stability

Financial stability is a critical aspect of effective running of a healthcare institution. At Palmetto Health Richland hospital, this can be achieved by

i. Creating customer-focused Outcomes environment within the healthcare institution

Financial stability of any healthcare system is an intertwined aspect that is always a consequence of many other quality processes. In order for Palmetto Health Richland hospital to improve its financial stability it has to cultivate the culture of focusing in impressing customers’ outcomes and good performance of the hospital’s stakeholders so as to achieve strategically set goals and targets. Patients and stakeholders’ satisfaction are important parameters for Palmetto Health Richland hospital to achieve enhanced financial stability (Lighter, 2011). Giving priority to patients’ outcomes and stakeholders’ performance will create loyalty in the healthcare system leading to greater financial stability and sustainability. E: key roles and responsibilities of stakeholders

Patients’ safety is an important aspect in Palmetto Health Richland hospital. Indeed, any healthcare systems work towards achieving optimum patients’ safety. In order to achieve patients’ safety, Palmetto Health Richland hospital should work and establish appropriate relationships with all the stakeholders who are involved in effective running of this healthcare system. The management of Palmetto Health Richland hospital must ensure that each stakeholder plays their role efficiently so that patients’ safety is achieved and eventually the overall performance of the hospital. The stakeholders who work hand-in-hand with this hospital include pharmaceutical industries, government, insurance companies, physicians, and patients.

Pharmaceutical industries

Pharmaceutical companies are directly involved in the safety of patients because they develop the drugs that are prescribed to the patients by the doctors. They have to play their role in conducting researches and developing quality drugs. More so, they have to ensure that their drugs are affordable to the patients, and therefore they have a responsibility to practice fair marketing of their products (Ballard, 2003).


The government has a role to play in the healthcare system. It should intervene the activities of the pharmaceutical industries to ensure that their products are affordable to all the citizens. This can be achieved by subsidizing the pharmaceutical products so that they can be sold to the patients at a cheaper and affordable price. Also, the government can support the pharmaceutical industries research and development activities so that their products will be at a fair price. This will demonstrate the government’s responsibility for the protection of its citizens’ rights to life and liberty by the provision of affordable healthcare systems.

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Insurance companies

Insurance companies play the role of providing health insurance and premiums to the patients. Current financial hardships, rising premiums and strict requirements are raising ethical questions because the insurance companies seem to be more focused to profit making than the quality of healthcare for the patients (Ballard, 2003). They should take their responsibilities of ensuring affordable plans so that more people can be covered.


Physicians play the central role in ensuring that the patients receive adequate care and controlling all the other stakeholders so that healthcare becomes affordable, and patients’ safety can be achieved. Their primary role is gate-keeping striking the balance between all the stakeholders. At all times, physicians should be responsible for the protection of patients’ interest as they are the link between the patients and all other stakeholders.


Patients have a responsibility of taking care of their own health and also in controlling the prices of healthcare. They should adopt healthy lifestyles that lead to reduced costs of health (Ballard, 2003). They also have a duty of forming good relationships with their physicians in making reasonable and cost-effective choices.

How to ensure stakeholder accountability and involvement

Stakeholders’ involvement and accountability are at the heart of every successful healthcare institution. At Palmetto Health Richland hospital, all the stakeholders’ involvement and accountability can be achieved by creating a committee for quality assurance. This committee should be entitled to the role of setting quality measures and evaluating the performance of every stakeholder (Institute of Medicine (US) Committee on Public Health Strategies to Improve Health, 2011). It should also set standards that ought to be met by all the stakeholders. The standards should be made the priorities for quality health, and they should be reinforced so that every role-player can take their part responsibly.

Training staff would need in order to implement the plan

The staffs at Palmetto Health Richland hospital need to be engaged in regular training on the technological medical equipments that the hospital will purchase so that they can be used effectively and for the betterment of the patients’ outcome. At least all nurses should familiarize themselves with Electronic Healthcare Records (EHR) and Computerized Physician/Provider Order Entry (CPOE). Also, the physicians need to get sufficient training on modern treatment measures such as robotic prostatectomy, radical prostatectomy, radiation therapy, proton-beam therapy, and intensity –modulated radiation therapy.

Timeline for implementation of the plan, including periodic review and checkpoints to measure progress

In order for Palmetto Health Richland hospital, to undergo a full reformation, this could take the duration of five years split into two checkpoints after every two and a half years. First of all, the reformation is expensive, and the hospital management has to establish a strategy for implementing this plan. The financial arrangement is crucial so that the proper running of the hospital activities will not be affected during the implementation process. The program could be implemented in parts. By the end of the first checkpoint period of the implementation process, the hospital should have purchased at least some instruments and the staffs associated with the instruments should have undergone training for their operation. Also, all nurses should have familiarized with the organization’s Electronic Healthcare Records (EHR) and Computerized Physician/Provider Order Entry (CPOE).

By the end of the second period, the hospital should have purchased all the modern technological instruments, and they should have taken all the staffs for training. Also, a committee for quality assurance and quality control should be formed at this juncture so as to assess the performance of the stakeholders. The committee should be able to bring together the government, the insurance companies, pharmaceutical companies, patients and physicians and show them the need for cooperation in enhancing patients’ safety. This means the hospital will have sufficiently reformed, and it would be running effectively meeting the needs and the expectations of patients. It will also be in a position to meet the family and patients satisfaction.

Process to assess the success of strategic plan

Achieving the implementation of this plan requires the collaboration of all the stakeholders. In order to evaluate the progress of the implementation of the plan, all the stakeholders should be involved in forming the goals and targets that the plan aims. The goals set should be SMART (Specific, Measurable, Attainable, Realistic and they should be time bound). Incorporating all the stakeholders in target settings puts all of them in a responsible position to achieving the goals set. The contribution of each stakeholder in achieving the goals set should, therefore, be assessed after the agreed duration.

After every evaluation of the plan, the management of the hospital should pass the results to all the stakeholders indicating the successes and the failures. It should also offer suggestions for the necessary steps that need to be taken to overcome the challenges that may be causing failures. This can be communicated during the Annual General Meetings (AGMs) where all the stakeholders are present.


Anthony, M., (January 31, 2004). "Shared Governance Models: The Theory, Practice, and Evidence." Online Journal of Issues in Nursing. Vol. 9 No. 1

Ballard, K. (September 30, 2003). "Patient Safety: A Shared Responsibility." Online Journal of Issues in Nursing. Vol. 8 No. 3

Berrett, B., & Spiegelman, P. (2013). Patients come second: Leading change by changing the way you lead. New York: Inc.

Huston, C., (May 31, 2013) "The Impact of Emerging Technology on Nursing Care: Warp Speed Ahead" OJIN: The Online Journal of Issues in Nursing Vol. 18, No. 2, Manuscript 1. DOI: 10.3912/OJIN.Vol18No02Man01

Institute of Medicine (US) Committee on Public Health Strategies to Improve Health. (2011).For the Public’s Health: The Role of Measurement in Action and Accountability. Washington (DC): National Academies Press (US).

Lighter, D. E. (2011). Advanced performance improvement in health care: Principles and methods. Sudbury, Mass: Jones and Bartlett Publishers.

Niall Brennan, Nicole Cafarella, S. Lawrence Kocot, Aaron McKethan, Marisa Morrison, Nadia Nguyen, Mark Shepard and Reginald D. Williams II. (2009). Improving Quality and Value in the U.S. Health Care System. Brookings.

http://www.brookings.edu/research/reports/2009/08/21-bpc-qualityreport Rodak, S. (September 4, 2012). Strategies to Boost Hospitals' HCAHPS Scores. Infection control and clinical quality.

Stevens, K., (May 31, 2013) "The Impact of Evidence-Based Practice in Nursing and the Next Big Ideas" OJIN: The Online Journal of Issues in Nursing Vol. 18, No. 2, Manuscript 4.DOI: 10.3912/OJIN.Vol18No02Man04

Studer, Q., Robinson, B. C., & Cook, K. (2010). The HCAHPS handbook: Hardwire your hospital for pay-for-performance success. Gulf Breeze, FL: Fire Starter Pub. Zimmerli, B. (2013). Improving Health Care Value through Shared Accountability. Health Care Reform Insights.

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