Queens Hospital Health Trust - Example

REPORT ABOUT QUEENS HOSPITAL HEALTH TRUST. Submitted to (INSTRUCTOR’S NAME) (INSTITUTION NAME) (ADDRESS) February 25th, 2009 By (STUDENT NAME) (INSTITUTION NAME) ABSTRACT This paper begins with a basic introduction giving an insight into the general background of Lister Ward as a part of Queens Hospital. It then goes on to detail the purpose of this report explaining its main aim of discovering the managerial challenges afflicting the ward so as to find the solutions to these challenges. Thereafter, the paper gives a description of the methodology that was used during the research work for this report. It gives a break down of the primary methods that were mainly used as well as the secondary methods used in small part. The paper then delves into Lister Ward’s current training provisions with a view of ascertaining the adequacy of the provisions or lack thereof. It gives a critical analysis of the training as well as recommendations as to how the training can be improved. A critique of the management and leadership is then given. This is followed by proposals concerning these management and leadership challenges. The conclusions and recommendation are then summarily provided on how best to improve the management of Lister Ward in its bid to adequately cater to the many patients it serves on a daily basis. TABLE OF CONTENTS 1. Abstract…………………………………………………………………… 2 2. Contents………………………………………………………………….. 3 3. Introduction: 1.1Background..................................................................................... 1.2 Purpose........................................................................................... 4 4 4. Methods …………………………………………………………………... 5 5. Current training provisions………………………………………………... 6 6. Adequacy of training……………………………………………………… 6 7. Management and leadership issues to be addressed………………………. 7-8 8. Proposals…………………………………………………………………. 9-12 9. Conclusions……………………………………………………………….. 13 10. Recommendations………………………………………………………… 13 11. Appendices………………………………………………………………... 14 12. References………………………………………………………………... 15 1. INTRODUCTION 1.1 Background Lister Ward is a constituent ward of Queens Hospital that caters to male patients. It is an integral division of Queens Hospital as it is a surgical ward that offers similar services to those of the main hospital. As such, it requires proper management much in the same way that a main hospital requires. Following the wards re- organisation, it has been experiencing several challenges that have undoubtedly been an obstacle in the adequate care of the ward’s patients. Most of these challenges can attributed to poor management a failure of leadership. 1.2 Purpose The main objective of this report is to pin point the various management and leadership issues afflicting the ward. This will help in identifying the solutions to these challenges and in turn increase the level of efficiency in the ward’s provision of healthcare services to their patients. 2. METHODS The methods of data collection used in this report were mainly primary methods. Some of the methods used included the use of questionnaires, interviews and observation. This was crucial so as to obtain information from both the staff and the patients on a first hand basis. It was also very helpful in that the response was almost always instantaneous meaning that less time was wasted in the collection of this data. It was also cost effective and more accurate. It is on the basis of these first- hand accounts and observations that the findings of this report were founded upon. Nevertheless, secondary methods of data collection were also used especially the use of the ward’s organizational records which were very helpful in analysing the ward’s past and present managerial practices. 3. CURRENT TRAINING PROVISION The current training provision at Lister Ward revolves around the recruitment of student nurses who learn/ train on the job. The training programme goes on throughout the year whereby each student is required to train for a minimum of six months. The selection criterion is strictly for those who studied nursing at the university/ college level. 4. ADEQUACY OF TRAINING The training of these nurses has proved to be quite inadequate as some of the student nurses graduated with poor results from nursing school. This, in turn, inevitably translates into poor provision of healthcare to the patients since it shows the student nurses in question had not grasped the principles of nursing fully upon graduation. This greatly compromises the standards of the ward and puts the lives of patients in danger. 5. MANAGEMENT AND LEADERSHIP ISSUES TO BE ADDRESSED A quick analysis of the ward’s day- to- day running clearly points towards massive loopholes in management and leadership as a whole. The following are some of these issues that need to be addressed urgently: 5.1. Division of Work – From the research conducted at the ward, it was concluded that the specialization lines are blurred with regards to the specific functions of workers. The Nurse Manger appeared to be the be- all- end- all of the ward whereas the junior staff seemed unsure of their specific duties. This points to a lack of clear guidelines as pertaining to the division of work at Lister Ward. 5.2. Authority and Responsibility- The research also brought to attention the lack of understanding concerning the lines of authority and responsibility. According to Wikiversity (2009), authority refers to the right of a superior to give orders to his/ her subordinates. The staff at Lister Ward did not seem to understand or acknowledge the authority of the Nurse Manager and this resulted in continual conflict in the ward. 5.3. Discipline- According to Wikiversity (2009), this refers to proper conduct in relation to authority and it was clearly lacking at Lister Ward. Matters were only made worse by the negative attitude of the Nurse Manger towards the subordinates. All employees have a responsibility to show mutual respect towards each other regardless of their authority or lack thereof. 5.4. Unity of Command- This basically implies that everyone working in the same line of activity should understand and pursue the same objectives (Wikiversity, 2009). At Lister Ward, the staff did not seem to exhibit this type of unity of purpose and this ultimately led to the lack of cohesion that was evident in the execution of duties. 5.5. Equity - There was a clear lack of equity towards the staff by the Nurse Manager. Employees should be treated kindly and justice together with impartiality must be meted out to create a good working environment for the junior staff. 6. PROPOSALS The actions that need to be taken on the Ward include the following: 6.1. Decentralization of management: A ward, though not as big or busy as a hospital, is nevertheless still a challenge to manage. It is wrong therefore for four surgical wards at Queens Hospital (Lister being one of them) to be managed by one Nurse Manager. The handling of four fully operational wards by just one person is extremely difficult and thus a decentralization of the administration should be put in place whereby each ward is managed by one person. According to Swansburg, (2002, p. 378), decentralization disburses power and authority all the way down to the operational units of an organization. This in turn helps enhance efficiency within each unit. This decentralization is closely linked to the division of work which is a major principle of management. It leads to the specialization of the workforce which in turn leads to an increase in labour efficiency. This principle is based upon the belief that when you separate a small part of work, there is an increase in worker speed and accuracy. This principle is especially true with regards to the management of a busy environment such as a hospital ward. 6.2. Proper planning: One of the most integral principles of management is efficient planning. Without a sound plan in place, a manager does not have a clear picture of where he/ she is going and this causes a lack of clear vision in an organization. This inevitably leads to shaky progress. The lack of planning in Lister Ward is evident in the debilitation it suffers from- poor and old furniture; the existence of draughts despite the central heating system in place; the location of the ward right next to a major thoroughfare leading to noise levels unacceptable in a healthcare institution; and so on. All these discrepancies point towards a negligence on the part of the management from the very beginning of the wards inception. To nip this in the bud, proper refurbishment should have occurred during the wards re- organization and upgrading. However, since it was overlooked then, it should be a priority of the new Nurse Manager to see that major renovation of the wards facilities is undertaken. This will easily be accomplished with a proper plan in place that highlights the specific facilities which require refurbishment; the time the refurbishment will happen to prevent interference with the wards activities; and the costs to be incurred. All this will only be possible with a proper plan in place. 6.3. Effective Recruitment: The fact that the ward is mostly run by untrained hospital nurses should be of major concern to the management as it puts into question the recruitment practices of the ward. An untrained workforce translates into danger as it puts the lives of hundreds of patients in harms way. Generally, recruitment is highly critical in the success of an organization but this is more so in health institutions because there are human beings involved as opposed to mere products. As a result, great emphasis must be placed on recruiting highly trained staff regardless of whether or not they’re still in training. The first recruitment criteria should be that all nurses/ student nurses should have passed well at college. In other words, there should be a set standard in recruitment. In addition to this set standard, aptitude tests should be incorporated with a strong leaning towards practical tests that all prospective employees should pass before admission into Lister Ward. From the research that was conducted, it was evident that there were very low standards in the selection of staff which in turn caused the low standards of service. Even more disconcerting was the fact that many of these untrained nurses were allowed to handle patients with limited supervision. To counter this, those in charge of recruitment should ensure that the untrained staff work together with the more qualified staff to enhance their learning process. In addition, an increase of staff to boost the workforce of the woefully understaffed Lister Ward should also be a recruitment priority. This will in turn go a long way in saving lives and even boosting staff morale as a result of the reduced work load. 6.4. Employee Motivation: From the research conducted, a lack of employee motivation was clearly evident. The relationship between the Nurse Manager and her juniors was very strained and unhealthy. This resulted in an environment of hostility which then resulted into a lack of motivation on the part of the nurses. It goes without saying that if the nurses are not motivated to work; they will not be able to give their best when treating patients which could easily lead to wrong diagnoses and general irregularities. This could then lead to the unnecessary and preventable deaths of patients. Therefore, to enhance the motivation of the staff, several things measures need to be put in place by the management. The most important is for a thawing of relations within the ward should be cultivated. This can be done through team building sessions; employee education; and increased remuneration. In this regard, the Nurse Manager should be educated about the need to show respect to her juniors. It is only through this that tensions can be eased. On their part, the juniors should be made to understand the principles of authority and responsibility as well as discipline. It should be made clear through staff education that superiors are given authority; authority which junior staff are subject to. If such an understanding is created, less friction will occur. 7. CONCLUSION In summary, it was discovered that Lister Ward had great potential as an integral arm of Queens Hospital to improve its provision of health care services. The only obstacle towards this is its management hence an improvement of management practices should be a matter of urgency at Lister Ward. 8. RECOMMENDATIONS The following is a list of things the management at Lister Ward should undertake to improve efficiency: Renovation of facilities. Frequent team building sessions to boost employee morale. The principle of equity should be encouraged within the management to prevent hostility from the subordinates. Improved/ professional training of nurses. Improved remuneration. Recruitment of additional and highly qualified staff. Regular education of the staff concerning their duties and responsibilities. 9. APPENDICES 10. REFERENCES Swansburg, R. C. 2002. Introduction to Management and Leadership for Nurse Managers. Jones and Bartlett Publishers, Ontario. Wikiversity. 2009. Principles of Management. Accessed on the 26th of February, 2009 from http://en.wikiversity.org/wiki/Principles_of_Management Read More