NURS5041: You have Recently been asked by your Unit Manager to Review some of the Clinical Issues Highlighted from a Number of Sources: Leadership for the Clinical Context Case Study, Singapore

Introduction

You have recently been asked by your unit manager to review some of the clinical issues highlighted from a number of sources, that require attention to improve practice. As you read through the information below, refer to the highlighted rows in Table 2 and make notes related to the following points:

a) Issues related to clinical practice that requires attention.
b) Current clinical indicators compared to National / International Benchmarks.
c) Analyse the clinical indicators to identify areas for improvement.
d) Think about how you might lead change in practices.

The Integrated Health Service (IHS)

The Integrated Health Service (IHS) was established in 2015 and provides a comprehensive, integrated health service. The service commenced as a Government commitment to improving health services covering community assessment through to acute care and back to community care. The health service achieved accreditation in 2017, having met the National Accreditation Health Standards.

Recently however, there have been a number of media news reports about overcrowding in the emergency department, patients not receiving the best care, and increased waiting times for elective surgery in orthopaedics and ophthalmology.

The media reports in brief include:

a) A report in daily newspaper that mental health patients had been waiting in the Emergency Department for 3 days before a bed was available in the Mental Health Unit.

b) In August 2019 a patient had surgery on the wrong limb which resulted in an amputation

c) The infection rate within the IHS was substantially higher that of other health services within the region. This has resulted in patients canceling their surgery, as they fear getting a severe infection

d) In September 2020 the local newspaper reported that a patient had died following cataract surgery. The newspaper alleged that the patient was given medication after surgery that they were allergic to, which resulted in death.

The Accreditation Agency has informed the Chief Executive Officer that the health service accreditation is now under review. The accreditation agency will require a report on the Clinical Indicators for the Hospital and may decide to include a site visit. If the health service loses its accreditation, funding from the Government and Private Health Providers will be decreased

Your role in this case study

In the interim, and as preparation for the next clinical audit, your Nurse Manager has asked you to help with leading change in ONE of the two areas highlighted in Table 2.

The assessment task/s

Choose:
Using the case study data as a starting point, choose ONE of the issues (highlighted rows) from Table 2.

Analyze:

Include a process or framework you could use in analyzing your chosen issue, using other data from the case study that are likely connected to the issue of choice. Think about ways in which you could gather accurate information (from your own area) to understand the factors impacting the chosen clinical issue.

Recommend changes for practice:

Formulate recommendations for leading change (improvements) in clinical practices based on relevant literature, and where applicable, health policies and/or guidelines from your own hospital or work setting, State, National, or International health authorities.