Culture of Change
1. Sarah
According to Lee et al. (2019), The Institute of Medicine (IOM) identifies patient safety as a critical concern in healthcare and the best solution is enhancing quality of care. “The IOM has emphasized the importance of creating a culture of safety in healthcare organizations to improve patient safety and quality of care” (Lee et al., 2019). Lee et al. (2019) has coined the phrase “safety culture” and defines it as the product of individual or group values, attitudes, perceptions, competencies, and patterns of behavior that determine the commitment to an organization’s health and safety Melnyk & Fineout-Overholt (2023) suggest that healthcare leaders are a key piece in implementing and sustaining a culture of quality, especially when it comes to an evidence-based practice approach to decision making in their organizations. Healthcare leaders must focus on creating an environment where staff and physicians feel comfortable to implement and sustain EBP for the purpose of improving healthcare quality and patient outcomes, as well as decrease costs (Melnyk & Fineout-Overholt, 2023). There are several ways in which a culture of quality can be created. Melnyk & Fineout-Overholt (2023) suggest competencies should be utilized as a mechanism for healthcare professionals to provide high-quality safe care. Competencies are great measurement tools for healthcare professional’s skills set and can help leaders guide the quality of care that is expected. The Quality and Safety Education for Nurses (QSEN) project focuses on a global nursing initiative with the purpose to develop competencies that would prepare future nurses who would have the knowledge, skills, and attitudes necessary to continuously improve the quality and safety of the healthcare systems within which they work” (Melnyk & Fineout-Overholt, 2023, p. 369). Studies have proven that leaders who are courageous and committed to establishing EBP as the driver for best practices have led to more effective teamwork, a more engaged and satisfied staff, improvements in patient care and patient outcomes (Melnyk & Fineout-Overholt, 2023).
Studies have proven that creating a positive, evidence-based, patient-centered culture has increased the quality in care of patients. Lee et al. (2019) describes a study showing the positive relationship between safety culture and patient falls. These studies also have measured patient/family-reported satisfaction levels and direct patient outcomes being related to the safety culture in healthcare organizations. Feldman et al. (2019) suggests that creating a culture of high quality in the healthcare field requires a focus on developing many leaders who are quality improvement experts as well as experts on patient safety and change management. Feldman et al. (2019) explains that to create a culture of high-quality it must develop slowly and include buy-in from all levels of care providers within an organization.
Colossians 3:23 states “whatever you do, work at it with all your heart, as working for the Lord, not for human masters” (NIV, 2020, p. 522). This verse is exceptional for this thread topic. Healthcare leaders must focus on creating a culture of high-quality care to set an example for their team. Utilizing evidence-based practice and competencies to hold their staff accountable and providing a positive and open-minded work environment is essential to sustaining a culture of quality.
Resources
Barker, K. L. (2020). Niv study bible. Zondervan.
Feldman, S. S., Buchalter, S., Zink, D., Slovensky, D. J., & Hayes, L. W. (2019). Training leaders for a culture of quality and safety. Leadership in Health Services, 32(2), 251–263. https://doi.org/10.1108/lhs-09-2018-0041
Lee, S. E., Scott, L. D., Dahinten, V. S., Vincent, C., Lopez, K. D., & Park, C. G. (2019b). Safety culture, patient safety, and quality of Care Outcomes: A literature review. Western Journal of Nursing Research, 41(2), 279–304. https://doi.org/10.1177/0193945917747416
Melnyk, B. M., & Fineout-Overholt, E. (2023). Evidence-based practice in Nursing & Healthcare: A guide to best practice. Wolters Kluwer.
2. Baker
There are several factors that must be addressed when implementing and sustaining a culture of quality within health care. Some of these factors include sufficient commitment from leadership, proper education and training, staff accountability, and open dialogue between health care providers and the patients they serve (Coles et al., 2020). While all these concepts play a critical role in maintaining a culture of quality within a health care facility, their effectiveness ultimately relies on leadership commitment and the dedication of leaders to establish a culture centered around evidence-based practice and continuous quality improvement at the workplace. In fact, health care leaders must create and sustain work environments where clinicians need to implement evidence-based practices and provide the best patient care. Furthermore, it is the responsibility of health care leaders to use the best EBP in their decisions, which models ideal behavior for other employees and ultimately provides the best environment and culture for informed decision-making and establishing a culture of competence and high quality for both employees and patients at the facility (Melnyk & Fineout-Overholt, 2023, pp.421-422). There are several leadership styles and strategies one can implement to instill a culture of high quality and evidence-based practice at their facility. These different styles are known as innovative leadership, transformational leadership, servant leadership, and authentic leadership. Innovative leaders tend to promote creativity, embrace change, and optimize resource utilization in new ways. Transformational leaders inspire followers to commit to delivering high quality care, encourage autonomy and growth, and ultimately improve patient outcomes by focusing on patient-centered care and continuous improvement at the facility. Servant leaders prioritize the well-being of team members through establishing a positive work environment, improving staff morale, and emphasizing the patient-centered care model through traits of empathy, compassion, and patient safety. Lastly, authentic leaders are transparent and rely on ethical behaviors and trust for effective EBP implementation, greatly value diversity and a culture of fairness and open communication, and correlate to higher levels of job satisfaction among employees, which increases the probability of staff members embracing change and evidence-based decision making at the facility (Specchia et al., 2021). Ultimately, each of these leadership styles have their own strengths and weaknesses to contribute to successfully establishing a culture of evidence-based practice and high-quality care at the workplace. Through embracing change and having leaders who are committed to both their employees and their patients, a culture of high quality and informed decision-making will take place.
Biblical Integration
James 1:4, “Let perseverance finish its work so that you may be mature and complete, not lacking anything” (Holy Bible). James encourages believers to embrace challenges and difficulties which allow for the development of endurance and spiritual maturity. The goal of this is for one to become more Christlike and experience a life full of growth and development while building a relationship with God along the way. This relates to quality improvement measures in health care in several ways. Primarily, the successful implementation of quality improvement measures requires perseverance and allows for health care employees to constantly work towards improvement. Furthermore, maturity within health care is established when one gains an understanding of the complexities of health care, which can only be achieved through learning experiences and successful collaboration with health care colleagues. In conclusion, this verse emphasizes the importance of perseverance as it leads to maturity and completeness. As health care professionals, this verse can be applied to ensure that a constant pursuit of quality improvement is established to provide the best possible experience for patients.
References
Coles, E., Anderson, J., Maxwell, M., Harris, F. M., Gray, N. M., Milner, G., & MacGillivray, S. (2020). The influence of contextual factors on healthcare quality improvement initiatives: a realist review. Systematic reviews, 9, 1-22.
https://doi.org/10.1186/s13643-020-01344-3Links to an external site.
Holy Bible – American Standard Version. (Original work published 1901)
Retrieved from: https://holy-bible.online/asv.phpLinks to an external site.
Melnyk, B. M., & Fineout-Overholt, E. (2023). Evidence-based practice in Nursing & Healthcare: A guide to best practice (Fifth Edition). Wolters Kluwer.
Specchia, M. L., Cozzolino, M. R., Carini, E., Di Pilla, A., Galletti, C., Ricciardi, W., & Damiani, G. (2021). Leadership styles and nurses’ job satisfaction. Results of a systematic review. International journal of environmental research and public health, 18(4), 1552.
https://doi.org/10.3390/ijerph18041552Links to an external site.
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