Healthy Work Environment Analysis of Velocity Care Urgent Treatment Center,
Healthy work environment (HWE) promotes clinical excellence in patient care, ensure patient safety, improve delivery of care, and enhance staff recruitment and retention (Wei, Sewell, Woody, & Rose, 2018). A HWE is safe, empowering and satisfying. According to the American Association of Critical-Care Nurses (AACN), there is inseparable association between healthy work environments and optimal outcomes for health care organizations, patients, health care professionals. Healthy work environment standards are identified as a critical blueprint that healthcare organizations and providers can employ to promote a workplace that foster patient outcomes and improve satisfaction among healthcare staff (AACN, 2016). This paper applies the AACN healthy work standards to explore the healthy work environment status at Velocity Care Urgent Treatment Center, Louisiana.
AACN Standards
AACN has identified six standards for creating and sustaining HWEs, which embody evidence-based and relationship-centered principles of performance. The six essential standards related to health work environments include effective decision-making, true collaboration, skilled communication, appropriate staffing, authentic leadership, and meaningful recognition. All the six standards are equally fundamental for sustainable outcomes. The standards support the education of all healthcare practitioners to deliver patient-centered care, emphasize evidence-based practice and quality improvement approaches. Skilled communication supports effective interpersonal interaction and teamwork. Skilled communication is a fundamental aspect of true collaboration (AACN, 2016). Collaboration ensures effective patient care, efficient team and a supportive environment. Physician and nurse leaders are partners in creating true collaboration to promote HWE. Effective decision-making is all about valuing nurse contributions and commitment in leading organizational operations, directing clinical care and policymaking (AACN, 2016). Involving nurses in decision-making improves satisfaction and leads to better patient outcomes. Appropriate staffing ensures effective match between nurse competencies and patient needs. Staffing influences the ability of healthcare workers to deliver safe, quality care. Meaningful recognition involves recognizing and valuing the contributions one makes. This recognition is an essential human need because it bring a sense of satisfaction and worth. Authentic leadership calls for nurse leaders to foster health work environments by being positive agents of change, role models of collaboration practice and team builders.
Setting of the assessment
The assessment of healthy work environment took place at Velocity Care Urgent Treatment Center, Medical Group Practice in Louisiana. It provides immediate, non-threatening care to walk-in patients. The assessment was carried out on March 7, 2021, from 1300-1900. I worked with the clinical mentor who helped with the Healthy Work Environment Assessment Questions. The assessment focused on the organization policies and process, provider experiences, triage room, emergency room and laboratory. Since the center serves only walk-in patients, I spend more time in the emergency room. I was able to interview four staff members and their responses and feedback formed the basis of assessment findings. The mentor works at the center while I do not. When I arrived, I made irrelevant personal impressions and opinions on the center’s healthy work environment that might cloud my judgment. In addition to that, the respondents were not forthcoming on some issues for fear of attracting ire of the management.
Assessment Findings
The respondents were interviewed on assessment questions, one at a time and their responses recorded down. The respondents gave favor responses related to the essential standards for establishing and sustaining healthy work environment. They acknowledged the involvement nurses in clinical decision making, nurses working with physicians to promote patient care, nurses getting support and resources they need to provide care and have zero tolerance to workplace abuse and disrespect. Staff members are provided with opportunities for professional and personal development. Patient and family perspectives are considered when treatment decisions are made. They praised the existing reward system and the ability to influence policies and procedures around them. However, majority gave unfavorable rating to skilled communication and appropriate staffing. Here is a sample of their responses.
When asked whether “support services are provided at a level that allows nurses and other staff to spend their time on the priorities and requirements of patient family care” (“Assessment question 12,” (n.d.)), one respondent said, “Sometimes I am asked to work longer shifts or work on my schedule day off. It is not really cool.”
In response to Assessment Question 15, one respondent complained of give orders without explanation in their interaction with physicians and management. “I phoned the physician because the patient’s health was rapidly declining and instead was told I talk too much.” I swore never to bring any issue when the manager dismissed my concern,” said another respondent.
Plan for the Future
From the data collected, the healthy work environment at Velocity provide opportunities for clinical support, recognition, development, professional autonomy and true collaboration. The emerging issues correlated with poor communication and inadequate staffing, however. Lack of effective communication leads to avoidable medical errors while high nurse/patient ratios lead to staff and patient dissatisfaction. Inadequate staffing is also associated with staff stress, burnout and staff leaving. Interventions to improve HWE at velocity are described in the action plan. The goal was to improve positive relationships between management, employees and patients and wise allocation of resources to staffing needs. Work pressure due to inadequate staffing can be reduced though nursing practice quality circle. Nurses to hold regular meetings to identify problems and propose solutions. Interventions to improve communication and interpersonal interaction are many. Nurse Managers and administrators can make themselves accessible and create for collaboration. They can also be supportive of open communication. Implement open-door policy to promote open communication. This makes nurses to feel comfortable accessing them to discuss or inquire something. Holding regular team briefings and team meetings can help promote communication skills of the staff. Use of communication tools and checklist is also key to improving communication.
Nursing Research Supporting the Plan
In a 2017 integrated literature review, Wang et al. examined the interventions that can improve communication between physicians and nurses. A search engine was conducted on CINAHL, Science Direct and Medline using keywords to retrieved relevant articles. Of the extracted studies, 11 met inclusion and exclusion criteria. The findings showed that team training, use of communication tools and electronic situation–background–assessment–recommendation documentation improved communication.
Conclusion
Healthy work environment is associated with optimal outcomes for nurses, patients and other healthcare providers. Each AACN standard is essential and inextricably associated with healthy work environments. The results of the assessment classify Velocity Care Urgent Treatment Center as unhealthy work environment. Skilled communication and appropriate are yet to be met. The action plan focuses on implementing strategies to improve communication, such as open-door policy, management making themselves accessing and promoting regular meetings to hone communication skills.
References
Assessment Questions. (n.d.). Retrieved March 10, 2021 from https://www.aacn.org/nursing-excellence/healthy-work-environments/assessment-questions
Executive summary. (2016). AACN Standards for Establishing and Sustaining Healthy Work Environments: A journey to excellence. Retrieved March 10, 2021 from https://www.aacn.org/nursing-excellence/standards/aacn-standards-for-establishing-and-sustaining-healthy-work-environments
Wang, Y. et al. (2017). Interventions to improve communication between nurses and physicians in the intensive care unit: An integrative literature review. International Journal of Nursing Sciences, 5(1), 81-88.
Wei, H., Sewell. K.A., Woody, G. & Rose, M. A. (2018). The state of the science of nurse work environments in the United States: A systematic review. International Journal of Nursing Science, 16; 5(3):287-300.doi: 10.1016/j.ijnss.2018.04.010.
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