delegation example in health care setting

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Principles of delegation

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DELEGATION EXAMPLE IN A HEALTH CARE SETTING:

DELEGATION EXAMPLE IN A HEALTH CARE SETTING Nannette Benincasa HCS 350 March 28, 2011 Kia Carter-Anderson, MA

OBJECTIVES:

OBJECTIVES Describe the impact of diversity, ethnicity, and culture on communication List theoretical principles of effective therapeutic communication Demonstrate the principles and theories of effective interpersonal communication in the roles of caregiver, educator, and manager of care “Delegation is a process and a condition” (Walczak & Absolon, 2001)

DELEGATION MODEL OR PROCESS:

DELEGATION MODEL OR PROCESS FIVE RIGHTS Right Task Right Circumstance Right Person Right Direction/Communication Right Supervision/Evaluation ( National Councils of State Boards of Nursing, 1995 )

DELEGATION IN THE WORKPLACE:

DELEGATION IN THE WORKPLACE Some factors to consider when delegating Understand Roles according to the 4 C’s of Initial Direction : 1. Clear 2. Correct 3. Concise 4. Complete Coordination of Care between and within Departments Emergency management roles Cultural Competence Personality: Subordination/Insubordination Timeliness Initiative Ability of staff to work as a team Conflict and conflict resolution Oversight Work ethic

STAKEHOLDERS IN THEIR HEALTH CARE ROLES:

STAKEHOLDERS IN THEIR HEALTH CARE ROLES “Stakeholders are individuals actively involved in the work who have an interest or may be affected by the successful completion of the work” ( Project Management Knowledge, 2010. p. 24, section 2.2) Examples : Physician Therapists Nurse Family Members Nursing Care Technician Patient Nursing Manager Pharmacists

HOW TO CHOOSE THE RIGHT STAKEHOLDER FOR THE JOB:

HOW TO CHOOSE THE RIGHT STAKEHOLDER FOR THE JOB Identify/Verify Competency and Skill Assess performance based on Standards of Care Assess responsiveness to 4C’s of Initial Direction Assess reliability, accountability, commitment Consider age, work ethic, role, personality & willingness to work as part of a team Follow up

PLAN OF ACTION:

PLAN OF ACTION How do you Communicate with Stakeholders? How do you Resolve Conflict? How do you know When to Give Feedback? How to Evaluate the Problem that is Solved? Relevant Recommendations

HOW TO COMMUNICATE WITH THE STAKEHOLDER:

HOW TO COMMUNICATE WITH THE STAKEHOLDER Initiate the task , suggest ways to approach problem, remind others of task requirements Clarify important facts using personal knowledge Support opinions and agree with good ideas Point out alternative views and methods Combine activities Encourage use of humor, friendliness, and divergent views Allow members to express their views Point out standards Remain neutral Restate ideas Assign tasks and roles

RESOLVING CONFLICT:

RESOLVING CONFLICT Individuals belong to Role Sets : “An association of individuals that share interdependent tasks while performing their own independent tasks” (Katz & Kahn, 1966) Role Sets Unique to Health Care : Physician nurse Nurse-rest of the world Nurse- assistive personnel Healthcare payors Five Choices for Resolving Conflict Avoidance : “There is no problem” Accommodation : “You win, I lose” Competition: “I win, you lose” Compromise: “We both win and lose some” Collaboration: “I win, you win” (Hansten & Jackson, 2009, pp. 308-313)

KNOW WHEN TO GIVE FEEDBACK:

KNOW WHEN TO GIVE FEEDBACK FIRST: Decide the Outcome You Want to Achieve , A situation that needs immediate action may require immediate feedback. Comment on observed behaviors preventing action and give direction Observe verbal and non-verbal behaviors that affect others negatively and share your concern with that person Criticize performance, not the person To modify behaviors over time focus on small changes Avoid giving feedback at a time or place that could embarrass or humiliate another person Consider giving positive feedback in the presence of others to build rapport and improve morale

HOW TO EVALUATE THE SOLVED PROBLEM:

HOW TO EVALUATE THE SOLVED PROBLEM STRATEGY: UNDERSTAND THE PROBLEM AND KNOW THE GOAL Evaluate for relevancy: Are results realistic and manageable? What are the consequences- good and bad? Did this help reach the goal? Was conflict avoided or resolved? Was the solution effective and help achieve the goal? Did the team perform within their roles? Were instructions: clear, concise, correct and complete? (the 4C’s of initial direction)

RELEVANT RECOMMENDATIONS:

RELEVANT RECOMMENDATIONS Effective communication and delegation builds strong teams and morale Discussing conflict related issues is essential Competency in communication, cultural diversity, and delegation among role sets promotes improved outcomes (Potter,2010) Nurse managers play a key role in facilitating delegation practices The Five Rights of Delegation and the 4C’s of Initial Direction are excellent tools for directing team delegation and obtaining optimum outcomes

REFERENCES:

REFERENCES Hansten, R. I., & Jackson, M. (2009). Clinical Delegation Skills: a handbook for professional practice (4th ed.). Sudbary, MA: Jones and Bartlett. Johnson D., & Johnson R.,(1987), Creative Conflict, Interaction Books, Edina, MN, 2, pp.27-28. Retrieved from http://faculty.ed.umuc.edu . On Jan. 1, 2011 Katz, Daniel and Kahn, Robert L. (1966). The Social Psychology of Organization. Retrieved from http://www.eoht.info/page/Daniel+Katz on March 26, 2011 Nuseibeh, B., Easterbrook. S., (n.d.), Requirements engineering: A roadmap. Retrieved from http://www.mcs.opne.ac.uk/ban25/sotar.re.pdf Ostrowski, E., Management coaching: How and when to give feedback.(n.d.). Retrieved from http://verycoaching.com/management-coaching-how-and-when-to-give-feedback on March 23 , 2011 Polya, G. How to Solve It, (2 nd ed.). (1957) Problem Solving Strategy. Adapted from Princeton University Press, Retrieved from http://pupress.princeton.edu/titles/669.html Potter P., Deshields T. & Kuhrik M., (2009). Delegation practices between registered nurses and nursing assistive personnel. Journal of Nursing Management 18, p.157-165.

REFERENCES (cont.):

REFERENCES (cont.) Professional practice model of care. Holistic equilibrium. University Health System for Bexar County and beyond. Retrieved from http://www . universityhealthsystem.com/professional-practice-model-of-care on March 20, 2011 Project management knowledge: Can you delegate stakeholder management? (n.d.). Retrieved from http://project-management-knowledge.com on March 25, 2011. Rotondi, A. J. (1999). Assessing a teams’ problem solving ability: evaluation of the Team Problem Solving Assessment Tool (TPSAT). Department of Anesthesiology and Critical Care Medicine, School of Medicine, University of Pittsburgh, PA 15213, USA. Healthcare Management Science. 1999 Dec. 2 (4): 205-14. retrieved from http://www.ncbi.nlm.gov/pubmed on March 25 , 2011 The Five Rights of Delegation. National Council of State Boards of Nursing, Inc. (1997). Retrieved from http://www. National Council of State Boards of Nursing. org on March 20, 2011 .

REFERENCES (cont.):

REFERENCES (cont.) Walczak, M.B., Absolon, P.L. (2001). Essentials for effective communication in oncology nursing: assertiveness, conflict management, delegation, and motivation. Journal of Nursing Staff Development. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/11998676 Watson J., Commentary on Shattell M (2004) Nurse-patient interaction: a review of the literature. Journal of Clinical Nursing 13, p. 714-722. Journal of Clinical Nursing ,14, 530-532. Blackwell Publishing Ltd

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