Organizational Changes within the Health Service and Their Influence on Health Care Delivery - Essay Example

TOPIC: ADVANCED NURSE PRACTITIONER (Name) (Course) (Institution) (Instructor’s name) 25th June, 2008 Introduction The health care is dynamic in nature due to the complexity of health care. This affects the role of nurses and the future role of nurses is definitely going to change. The world changes in technology also influence the provision of health care in the society. There are also several challenges that nurses face in provision of services due to this dynamism of the nursing professional. The nurses are aware of these challenges and need to manipulate their roles to be more reliable in the health sector rest the quality of health care will never improve. This paper looks at three parts of health care provision by nurses in three major dimensions. The first one looks at the organizational changes in the health care service with their effects on health care delivery. The second part of the paper will discuss the changing role of nurses and its influence on the quality of health care, while the last part examines West Yorkshire interpretation of the Influenza pandemic and the efforts by nurses to the solution of the pandemic. Organizational changes within the health service and their influence on health care delivery The organization in the health care has improved with several changes taking a lead in the provision of health care. The organizational changes are aimed at improving the delivery of health care services to the public. Some of the organizational changes in the health care are controlled by policies that are directed to correct the errors in medical care and the series of scandals which has propelled the issue of quality health care to a point of no return. Policies to improve quality health care are a key area in organizational changes described by the policy of quality health care as the key to quality improvement. Cultural changes in the health care have also participated in changing of the organization of the health sector. (Bowcutt and Goolsby, 2006) Due to these changes in the organization of the health care, the delivery of health care services has improved not only at local levels, but also to National levels. This is a result of establishment of a culture where excellence in delivery of health care can flourish. The review of policies in health care in the United Kingdom over the last two decades with an appeal for cultural change appears in different guises and in was not a new thing only that it had not been taken seriously in the health sector. Policy reviews in the previous reforms in the National Health Service had invoked this notion of cultural change in the organization of health care. The reforms which were inspired by Sir Roy Griffiths brought about development of general hospital management. This general management resulted to greater involvement of nurses and all clinicians in important areas in management of hospitals especially budgeting through the hospital resource management initiative. These reforms had themes that conformed to the market reforms of the beginning of 1990’s. These reforms separated out purchasers’ and providers’ functions. The reforms increased the management and the accountability in the National Hospital Service thus developing a more business culture in the health care provision. This could also increase government revenue and minimizing over reliance of the National Hospital Service to the government. These changes however faced challenges and resistance which were more evident than acceptance of the transformation process. (Langfield,1995) When the labor government came into power in 1997, they made these reforms a success and improved the quality of the reforms in the National Hospital Service. The new quality strategy was set in the government White Paper 12 with documents supporting the policy, 6 and 13 which represented a determined attempt to enhance an over arching framework for quality of health care. These documents consist of a detailed set of strategies to reform the organization of the health care through changing management of National Hospital Service with three main factors; to define suitable quality standards, to deliver health care congruent with the set standards and lastly the monitoring process to ensure that high quality health care service is maintained at all levels. The delivery of health care highly conforms to the cultural organization policy of the NHS. The strategy official document stresses on interlinking of clinical governance that give the nurses the opportunity to leadership responsibilities in the hospital, lifelong learning meant for promotion of health care delivery and self regulation of professionalism that make the clinicians to work independently. The introduction of the changes in the health care services gave nurses a clear dimension in exercising their professional career. Freedom and involvement in the management is the way forward to improve the delivery of the health care service delivery. In order to achieve a significant and sustainable quality improvement in the NHS needs essential change in the organization culture and to focus effort where it is needed enabling and empowering the nurses in the NHS to improve quality at local level. Clinical governance desires to be underpinned by a background that puts value to lifelong learning and recognizing the central areas it plays to improve quality of health care delivery. Organization culture provides a clear view of the changes in health care organization. The use of this idea of organizational culture to organizations began in United States after the World War II and gained popularity in the 80’s. In the health care sector the organizational culture theory was instilled in the 1990’s improving the performance of the health care organization. Since the management of the National Hospital Service was changed, the delivery of health care improved significantly due to the utilization of resources that before then were misused by the managers and other stakeholders in the NHS. This kind of changes brings about development in an organization and the resources go right to the desired projects. The improved technology in delivery of health care in hospitals has made it a success of the organization changes. Nurses and doctors are able to diagnose patients faster than before and data storage is necessary for future treatment of the patient. The society expectations from the health care service were heightened with organizational changes. Organization culture can be understood in two ways, the first one is the family approach which describes an organization as being a culture itself. This school of thought recognizes an organization as culture. The second thought is the post modern perspectives of an organization. This notion separates organization and culture as two different entities. According to this approach, culture is separable from organization. Nurses have therefore the mandate to succumb to necessary changes within the organization as long as they are aimed at improving health care delivery. In terms of health care, differentiation of culture from organization is important and helpful. However, the more visible elements of culture may be readily manipulated while strong beliefs and values may be more resistant to influence from outside. Evidence from the NHS shows that, attempts in cultural transformation only succeeded at a superficial level. The Griffiths' reforms of the 1980s were trying to superimpose a clear management culture onto an organization with an elegant public service orientation. Changing role of a nurse as a member of the multi-professional team Nurses in the past (1960’s) had not been acquiring a bachelors degree in clinical medicine. With the current changes in education, nurses are acquiring higher education at university with degree in nursing. This gives the nurses a chance to be registered as designated nurses under the law and professional ethics. This change in education of nurses gives them a wide range of opportunities to participate in various departments in the delivery of health care. Nurses play a major role in the society as far as health care is concerned. Nurses therefore do all the necessary duties that range from leadership, counseling, administration and management in the hospitals. As it have been noted above about the reforms in the management of the National Hospital Service, It is evident therefore that nurses also engage in management of hospitals. In America, hospitals even employ BSN students in the hospital that help greatly in running the hospital as nurses and managers. Hospitals do not in fact need any professionals from outside for management as they can entirely carry out comprehensive duties in the health care delivery. The America Nurses Association, demands the employment of baccalaureate nurses in big numbers as compared to nurses at other levels. This offers hospitals with magnet status thus improve the quality of health care service to patients. Nurses also take different roles in the health care delivery to curb the shortage of nurses in the world. It is predicted that by the year 2020, the commonwealth will have a shortage of 22,000 nurses. This inspires the nurses in the sector to take diverse roles. When they take the leadership responsibility, nurses has a greater chance of making independent decisions which are vital in the provision of quality health care. The shortage of nurses is a serious crises in any state and unless this problem is addressed through increasing enrollment of nurse students in schools faculty of nursing. (Blau,1996) Technological changes allow nurses to carry out several duties within a hospital environment. Nurses are able to carry out data collection and analysis in both health care issues and management issues. Shift in patient population creates new issues in nursing. The fastest population growth some 50 years ago was children’s population; currently however, the population of the aged patient is in the increase instead. This forces nurses to learn different roles in health care delivery. The elderly were not given more attention back then because they used to die at their late. The nurses have to adjust to all this changes occurring in the health care for them to provide quality services. The training of nurses deals with different issues involving thorough examination of nursing both theoretically and in practice. The issues dealt with by nursing practitioners in clinical decision making and as well as management, are well learnt by nurses in obstetrics, gynecological department and also in emergency wards. Counseling by nurses is a common thing as they are required to counsel their patients and advising them too. Nurses also require wide knowledge over different illness in order to know how to handle patients if at all high quality health care services will be delivered. In case of depressed patients, counseling is emphasized as well as psychological support. Reflective practice on the other hand is recommended when treating patients with high blood pressure, or injured person after a serious accident. The nurses play various roles including that of a psychiatrist. (Langfield,1995) Nurses are also managers as they work in a busy environment. They are required to make decisions sometimes independently without having to consult the management or family members in times of emergency operations in the hospital. Nurses can be very flexible to their patients and can ask them on their opinion (Patient centered outcome) Clinical management can be related to leadership theories. It is therefore important for a nurse to build up adequate leadership skills to successfully perform clinical duties. Social and healthcare policies and guidelines on clinical governance advocate for a multidisciplinary mutual working approach in order to achieve an effective clinical management. Teamwork, psychosocial treatment and fair allocation of clinical resources are important issues within health care in intensive care unit (ICU) and also for concern of emergency patients. (Blau,1996) In general, the legal ethical responsibilities of nurse practitioner and the medical team are mostly guided clinical guidelines set by the Department of Health and by a team of dedicated clinical professionals in a hospital setting. The diversion of the role of nurses in their work to various duties in a hospital helps to improve the quality of health care provision. Leadership styles applied in the right way by nurses enhance the smooth running of the hospital as it enhances organizational changes. Critical analysis on influenza pandemic in District Nursing West Yorkshire A health aspect in West Yorkshire is the pandemic flu, influenza. This pandemic has not been taken seriously by the residents in West Yorkshire. Different agencies undertook a preparedness campaign for the pandemic but results shows that people take the matter very lightly. A health aspect like this one which is a pandemic should be taken with great concern by the people. However people do interpret this operation by agencies as just a normal operation on health matters carried out regularly to educate people on health issues. Despite the efforts of the department of health in West Yorkshire to publish several guidance articles to support the campaigns, there has been very poor response regarding this issue. This shows that the efforts of the England health department about possibility of influenza have been misinterpreted by the citizens. The impact of influenza may be a major health knock in care homes particularly in unprepared situations. A rapid survey that has been undertaken in a few care homes (both local authority and private owned homes) in West Yorkshire assessing preparedness showed that very little had been done in preparation for the pandemic. Therefore planning for this pandemic will require coordination across the different sectors in health care provision probably, proper coordination may be through Local Resilience Forums. (Bowcutt and Goolsby, 2006) District nursing role of the public health is poorly defined as compared to other branches of community nursing. In a qualitative study that examined the public health role of district nurses undertaken in one of West Yorkshire primary care trust, which explored the range of public health activities presently taken by district nurses, some agendas seen as the most conducive to contribution and the organizational barriers. References Blau, P. (1996), Role of Leadership in Nursing, (London, University of Chicago Press) Deal, T. (1999), New Corporate Cultures, (London, Macmillan Publishers) Harrison, S. et al (2000), Just Managing: Power and Culture in the National Health Service, (London, Macmillan Publishers) Langfield, K. (1995), Management Control: Theories Issues and Practices, (London, Macmillan) Booth, J. and Davies, C. (1991) The management of change on a nursing development unit, (New York, McGraw Hill) Bowcutt, M. and Goolsby, J. (2006) The clinical nurse leader: promoting patient-centered outcomes (London, Oxford University Press) Gibbs, G.. (1988), Learning by doing: a guide to teaching and learning methods (London, Further Education Unit) Read More