Using Predictive Analytics to Improve Healthcare Outcomes. Группа авторов

Using Predictive Analytics to Improve Healthcare Outcomes - Группа авторов


Скачать книгу
Delivery

      7 System Design

      8 Evidence

      Like many frameworks of care, RBC engages staff councils in embedding its principles into the structures, processes, policies, and people in the organization. Most of the case studies in this book were carried out in organizations that practice RBC. Operationalization of the RBC model uses the powerful formula for change outlined in the book I2E2: Leading Lasting Change (Felgen, 2007) as it is key to a successful transformation. Appendix B offers a description of the I2E2 formula.

      Another framework of care, which is reviewed at length in the international section of this book, is the Caring Behaviors Assurance System (CBAS). CBAS has six dimensions, which are based on the “7 Cs” derived from a 2010 paper published by the Scottish government, called The Healthcare Quality Strategy for NHSScotland [sic]. You will see that two of the 7 Cs are combined in the first dimension:

      1 Care and Compassion

      2 Communication

      3 Collaboration

      4 Clean Environment

      5 Continuity of Care

      6 Clinical Excellence

      Unlike RBC, CBAS has an extensive method of measuring the degree to which the concepts of caring are taking hold in practice, employing three separate measures, including an assessment of how job satisfaction is being impacted by its implementation. Having a rigorous method of measurement specified for a framework of care helps advance and sustain the framework of care in several ways. It identifies (a) what specific components of the framework can be shown to relate to improved outcomes, (b) what components of the framework are critical for staff members to embrace in order to enact the framework of care, and (c) where the important components of the framework are working well within the organization and where they need additional support. The measurement process for CBAS accomplished all of these things. Implementation of CBAS in 18 hospitals in Scotland is reviewed in detail in Chapter 18.

      Some theorists assert that Watson's Theory of Transpersonal Caring (2008a) is a framework of care when the processes of caring behaviors are taught with the intention that they be carried out within operations of care. While the implementation of any processes of caring in the absence of structures, processes, and policies to support the sustaining of the behaviors cannot be called a framework of care, the implementation of Watson's caring behaviors is an integral part of several frameworks of care delivery.

      Later in this book, as case studies are presented in which people working in Relationship‐Based Care cultures have had success in using predictive analytics to improve outcomes, they often credit the success of the project—or even the very existence of the project—to what they have learned while implementing RBC. Often, what they credit, however, is some of the long‐honed wisdom baked into the process of implementing RBC that is not readily apparent in the dimensions of the model itself. You will see references to responsibility + authority +accountability (R+A+A), Primary Nursing, the importance of clarity, and more. In order to help you better understand those concepts when you meet them in your reading, here is a summary of each concept.

      The Three Key Relationships in Relationship‐Based Care

      The most central tenet in Relationship‐Based Care is that every relationship matters. Therefore, it is essential that all people in the organization tend to the quality of their relationships with themselves (self‐awareness), with their colleagues, and with patients and families. Many discussions of these three relationships also focus on “care of” self, colleagues, and patients and families.

      Relationship with Self/Care of Self

      To stay healthy and be emotionally available for others, clinicians must pay attention to their own energy levels, be self‐aware and mindful as they interact, and practice self‐care for body, mind, and spirit.

      Relationship with Colleagues/Care of Colleagues

      Healthy interpersonal relationships between colleagues positively impact the patient experience. All team members must model mutual respect, trust, open and honest communication, and consistent, visible support of one another.

      Relationship with Patients and Families/Care of Patients and Families

      In RBC cultures, patients are seen, heard, and cared for as distinct individuals. Care and service are designed to prevent unnecessary suffering due to delays, physical or emotional discomfort, and lack of information about what is happening. The care delivery system of Primary Nursing, which is explained later in this chapter, is used because it is the system most supportive of the nurse–patient relationship (Manthey, 1980; Wessel & Manthey, 2015).

      Several chapters in this book document studies seeking to understand the relationship between care of self and/or the care of the unit manager and nurse job satisfaction.

      Responsibility + Authority + Accountability (R+A+A)

      The theoretical framework known as R+A+A has appeared in nearly every book Creative Health Care Management (CHCM), the originators or RBC, has published (Felgen, 2007; Guanci & Medeiros, 2018; Koloroutis, 2004; Koloroutis & Abelson, 2017; Koloroutis, Felgen, Person, & Wessel, 2007; Manthey, 1980, 2007).

       Responsibility

       Must include the clear articulation of expectations

       Always a two‐way process: responsibility must be both allocated and accepted


Скачать книгу