The following paper deals with the analysis, comparison and discussion of several approaches and theories concerning important issues in the course of nursing practice from the perspective of leaders and managers. The area of nursing performance that has been chosen for the current analysis is as follows: continuous quality improvement and patient satisfaction. This scope is topical in the current course of time as far as it has sufficient background to rely upon in the process of investigation and analysis as well as significant perspectives for further research.
Analysis and Discussion
The issues of continuous quality improvement and patient satisfaction are closely connected. Actually, they predetermine the level of overall efficiency of the professional performance provided by nursing staff. The process of continuous quality improvement is necessary in order to provide appropriate level of nursing in correspondence to advanced technologies as well as innovative methods and techniques.
It is relevant to start the current discussion with the perspective presented by ANA (2009). The purpose of the course of continuous quality improvement is to provide: Consistent, high-quality care that eliminates disparities based on socioeconomic and geographic factors. The quality of care must be maximized by encouraging collaborative teams of health care professionals to provide well-coordinated services and practices based on evidence of what treatments are most effective in producing the best outcomes.
It is crucial to underline one more significant aspect of the course of continuous quality improvement in terms of nursing care: it should be gradual, relevant and consistent. The changes should be properly introduced to the working staff. Special attention should be paid to new members of the nursing staff. New employees should comprehend the currently existing system properly in order to realize the urgent necessity and significance of the alterations, which will be implemented in the course of continuous quality improvement. As soon as they realize their significance, they are ready to accept and follow them. Actually, experience becomes an essential factor that predetermines further improvement and development of the changes, which have been incorporated in the nursing practice as well as its subsequent level of efficiency of the alteration policy. Moreover, the nursing staff should be prepared to the incorporation of the changes as well as to the outcomes of every alteration that has been planned to be implemented. The change policy should correspond both to the needs of nurses and patients. It is a very essential aspect from the perspective of managers, whereas leaders emphasize the following: the priorities should be properly put in the course of changes’ implementation in order to provide efficiency and consistency of the process. For instance, constructive approach and efficient team work should be prioritized in case there are apparent problems within the working staff or when there are several newcomers.
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It is also appropriate to discuss such a relevant aspect of the currently discussed issue in the nursing practice as principles of continuous quality improvement. “Guide to Implementing Quality Improvement Principles” (n.d.) underlines specific significance of the following principles: “Make data-driven decisions; work as a team; improve entire processes of care or systems of care delivery, rather than targeting individual performance.” It is relevant to discuss these principles in details. For instance, the principle of data-driven decisions is connected with systematicity and efficiency of the course of continuous quality improvement. Hence, this principle is also related to the outcomes of the course of quality improvement and patient satisfaction. Moreover, the principle of team work is also a crucial one within the framework of nursing priorities and values. It is necessary for any kind of change implementation in the course of continuous quality improvement as far as it guarantees consistency, mutual support and assistance as well as higher level of efficiency of professional performance. It is especially important in case when there are several active leaders among the nursing staff in order to provide cooperation motivated by means of competitiveness, ambitions and responsibility. Furthermore, the principle of improvement of all the processes of care as well as systems of care delivery, rather than targeting individual performance is also essential. “It is often more difficult to find fault with processes or systems than with individuals… When there are fewer opportunities to make mistakes, fewer mistakes will be made”.
One more approach that is relevant in terms of the current discussion is the theory of Five Cs of leadership that has been presented and developed by Kowalski and Yoder-Wise (2003). The elements of this theory are as follows: character, commitment, connectedness, compassion, and confidence.
The phenomenon of character is a crucial one, and, therefore, it is closely connected with the notion of commitment. The concept of character involves certain standards and values in terms of outlook, faith and prioritization. This notion tends to predetermine the phenomenon of commitment that is comprehended as “being able to return to a situationin which staffing and patient challenges are unrelenting”. Managers regard the notion of commitment as the capability to rally the ‘resources’ one more time, whereas leaders regard it as the capability to motivate staff members and be enthusiastic about every change in the course of quality improvement even if it has failed the previous time. The notion of connectedness is crucial as far as the scope of nursing practice is directly related to the communication and interaction with people (leaders, managers, colleagues, and patients). It is important to establish and develop credibility in order to provide relevant and constructive connectedness, according to the leaders’ perspective. “Understanding how people feel and think helps create relationships”. The element of compassion is also important in the course of continuous quality improvement as far as it elicits the phenomenon of humanity that is a central notion in the framework of the concept of nursing activity both for leaders and managers. The significance of the notion of confidence is supported by leaders as far as it assists to develop both personally and professionally. Moreover, it is a central element that is necessary in order to provide the capacity to help others develop and improve. Hence, the approach to the issue of continuous quality improvement that relies upon the Cs of Kowalski and Yoder-Wise (2003) is constructive and relevant in terms of nursing professional performance.
The diversity of approaches to the issue of continuous quality improvement demonstrates its multifaceted nature. Hence, every approach is significant as far as it reveals and covers certain aspect of the currently discussed issue. Though, I consider the perspective provided by Kowalski and Yoder-Wise (2003) to be the most efficient, constructive and potential as far as it involves all the key aspects which should be taken into consideration in the course of improvement. Moreover, every element is connected with another one so that the theory forms the functioning system.
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