Developing Organizational Policies and Practices
Assignment: Developing Organizational Policies and Practices
Competing needs arise within any organization as employees seek to meet their targets and leaders seek to meet company goals. As a leader, successful management of these goals requires establishing priorities and allocating resources accordingly.
Within a healthcare setting, the needs of the workforce, resources, and patients are often in conflict. Mandatory overtime, implementation of staffing ratios, use of unlicensed assisting personnel, and employer reductions of education benefits are examples of practices that might lead to conflicting needs in practice.
Leaders can contribute to both the problem and the solution through policies, action, and inaction. In this Assignment, you will further develop the white paper you began work on in Module 1 by addressing competing needs within your organization.
To Prepare:
Review the national healthcare issue/stressor you examined in your Assignment for Module 1, and review the analysis of the healthcare issue/stressor you selected.
Identify and review two evidence-based scholarly resources that focus on proposed policies/practices to apply to your selected healthcare issue/stressor.
Reflect on the feedback you received from your colleagues on your Discussion post regarding competing needs.
The Assignment (4-5 pages):
Developing Organizational Policies and Practices
Add a section to the paper you submitted in Module 1. The new section should address the following:
Identify and describe at least two competing needs impacting your selected healthcare issue/stressor.
Describe a relevant policy or practice in your organization that may influence your selected healthcare issue/stressor.
Critique the policy for ethical considerations, and explain the policy’s strengths and challenges in promoting ethics.
Recommend one or more policy or practice changes designed to balance the competing needs of resources, workers, and patients, while addressing any ethical shortcomings of the existing policies. Be specific and provide examples.
Cite evidence that informs the healthcare issue/stressor and/or the policies, and provide two scholarly resources in support of your policy or practice recommendations.
Due to the nature of this assignment, your instructor may require more than 7 days to provide you with quality feedback. CORE SKILL: recognizing COMPETING NEEDS — the assignment’s whole premise is that organizational goals, workforce needs, and patient needs pull in different directions, and that policy is how the tension is adjudicated rather than dissolved.
NAME THE TENSION EXPLICITLY. Generic examples: cost containment vs. adequate staffing; throughput/length-of-stay targets vs. patient readiness for discharge; productivity metrics vs. time for patient education; EHR documentation requirements vs. bedside time; antibiotic stewardship vs. individual clinician autonomy; patient satisfaction scores vs. appropriate refusal of unnecessary opioids or antibiotics (this last is a genuinely sharp example — tying reimbursement to satisfaction scores creates measurable pressure to prescribe things that aren’t indicated).
THE ETHICAL FRAME: this is DISTRIBUTIVE JUSTICE — allocating finite resources among competing legitimate claims. Use the four principles, and be precise about which two are colliding. Also name UTILITARIAN (greatest good for the greatest number, which is how population-level policy tends to reason) versus DEONTOLOGICAL (duty-based, which is how bedside clinical ethics tends to reason) approaches — and note that a policy can be defensible utilitarian-wise while producing a duty violation at the bedside. That is exactly what MORAL DISTRESS is: knowing the right action but being constrained from taking it. Jameton’s original formulation, and the concept of MORAL RESIDUE (the accumulated cost of repeated moral distress) are worth citing, because they explain why this is not merely an abstract problem — it drives attrition.
POLICY ANALYSIS STRUCTURE: identify the competing needs → identify a specific policy that addresses (or fails to address) them → evaluate whether the policy actually reconciles the tension or merely shifts the burden (usually onto frontline staff — an observation that earns marks) → identify ethical shortcomings → recommend changes with evidence.
ETHICAL SHORTCOMINGS TO LOOK FOR IN REAL POLICIES: policies that assign responsibility without authority; policies that hold staff accountable for outcomes they cannot control; policies that are unfunded (mandating an intervention without providing time or staff to do it); policies that create a reporting duty while punishing reporters (the death of just culture); and policies that ration implicitly rather than explicitly, which shifts an institutional decision onto an individual clinician at the bedside.
CITE: the ANA Code of Ethics (Provision 6 addresses the ethical ENVIRONMENT of the workplace, which is directly on point and underused by students), relevant professional standards, and empirical literature on the specific issue.
RECOMMENDATIONS: must address the competing need, not wish it away. Acknowledge what your recommendation COSTS and who bears it — a recommendation with no trade-off is a fantasy.
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