Running head: LEADERSHIP STATEGY ANALYSIS

Leadership Strategy Analysis

Lindsey Koch
Tiffini Jarstfer
Wendy Debruyn
Toya Ozark
Ferris State University

LEADERSHIP STRATEGY ANALYSIS

Abstract
Effective nursing communication is imperative to high-quality overall patient outcomes.

Nursing communication occurs on a continuous basis whether it is between the patient and nurse,
nurse and patients family, nurse and physician, or nurse with co-workers. Being able to have
strong nursing communication skills is an asset to everyone involved in the healthcare system.
Studies continue to show that nursing communication is an area that has persistence for
improvement. Evidence-based practice shows that inefficient nursing communication can be
harmful to patient outcomes. Upgrading the workflow to boost nursing communication in all
areas of care is the long term goal for progress to combat the lack of nursing communication.

LEADERSHIP STRATEGY ANALYSIS

Leadership Strategy Analysis

As nurses go about their tasks and strive to provide excellent care to their patients, the
common gesture of communication is often missed or lacked. Nurses must communicate with
their patients effectively and frequently in order to provide quality care. Evidence based practice
shows that improved nursing communication leads to better patient outcomes.
In healthcare, quality improvement is an ongoing process. Quality improvement is
important in healthcare because it allows healthcare professionals to provide the highest quality,
safest, most efficient, and cost-effective care possible (Yoder-Wise, 2011, p. 390). In order to
make an improvement: a problem must be identified, an interdisciplinary team must be formed,
data must be collected, outcomes must be established, and strategies must be implemented. The
issue discussed in this paper is nursing communication with patients.
Clinical Need
Many hospitals and healthcare organizations use a system called HCAHPS (Hospital
Consumer Assessment of Healthcare Providers and Systems) to evaluate the patients
perspective of their care (Studer, Robinson, & Cook, 2010, p. 1). Patients are given a survey after
discharge. One of the main focuses of this survey and evaluation is nursing communication.
Patients are asked the three following questions in regards to nursing communication: During
this hospital stay, how often did nurses treat you with courtesy and respect? During this hospital
stay, how often did nurses listen carefully to you? During this hospital stay, how often did nurses
explain things in a way you could understand? Patients answer these questions with the choice
answers of never, sometimes, usually, or always (p. 43). This survey evaluates how well the
nurses communicated with the patient throughout their stay.

LEADERSHIP STRATEGY ANALYSIS

The most recent posted survey results took place in October 2012 through September
2013. In Michigan, 80% of discharged patients answered always to the nursing communication
questions. However, some states had a rate of 72%. This shows that 20-30% of patients feel that
their nurses did not communicate well with them during their hospital stay (HCAHPS, 2014).
This is where improvement can be made.
Interdisciplinary Team
The interdisciplinary team for this quality improvement team includes the clinical staff
and nursing managers. The clinical staff includes registered nurses, licensed practical nurses, and
certified nurse aides. The clinical staff plays the most important role, as this is who the patient is
evaluating. Nurse Managers have the responsibility of monitoring and encouraging the team.
Managers must act as leaders and ensure the staff is working effectively towards their goals.
Data Collection
Collecting data and sending out surveys to patients will always take place. This is
because quality improvement is constantly a goal for the multidisciplinary team (Yoder-Wise,
2011). Until the end of time, healthcare experiences constantly can be enhanced in some way,
shape, or form. To accomplish this there are many data tools that can be utilized for success by
the team. Some data tools could be flowcharts, line graphs, histograms, Pareto charts, and
fishbone diagrams (Yoder-Wise, 2011, p. 396). Nursing communication is a complex area of
healthcare as there are a variety of variables that can sway survey results. For difficult areas
requiring data collection a meticulous flowchart works the best (Yoder-Wise, 2011). The
flowchart can help staff understand the data better.

LEADERSHIP STRATEGY ANALYSIS

Using a quantitative method to collect data via surveys with an organized standardized
question sequence produced the most accurate results. HCAHPS is the survey utilized by the
quantitative method. A third party company called Press Ganey sends out standardized surveys
to a random number of patients. Press Ganey then either sends the survey to the patient by
electronic mail or uses the postal service for delivery (Giordano, Elliott, Goldstein, Lehrman, &
Spencer, (2009). Participation is voluntary, but clinical staff can communicate with the patients
the necessity of valuable information from the data collected on the surveys in hopes of getting
more filled out and returned for analysis.
Nursing managers and clinical staff have the ability to work with up-to-date data as their

target goal from month end information was composed. Having the data presented in a bar graph
showing the overall percentage by month allows staff to have real time data. Knowing where
clinical staff ranks in regards to the current standards of care demonstrated with nursing
communication permits the staff to make adjustments as needed for improvement.
Outcomes
The overall goal is to improved patient responses to the three nursing communication
questions in the HCAHPS survey from 80% to 90%. Improving communication with patients in
turns improves the patients perceptions of the quality of nursing care they receive. Therefore the
goal is to make sure that nurses increase communication with the patient, even about the survey.
Strategies
Strategies identified to implement an improvement is nursing care are based on five key
areas identified in the HCAHPS survey (Rochin, 2012, p. 18). The five key areas identified in the
HCAHPS survey are nursing communication, staff responsiveness, pain management,
communication of medications, and discharge information (Rochin, 2012, p. 18). In order to

LEADERSHIP STRATEGY ANALYSIS

improve the patients perception of their health care experience the healthcare team must engage
and involve the patient in all aspects of their healthcare.
Nurses can increase communication in several ways. Nurses can assess patients pain by
doing a pain assessment with each patient encounter, educate patients on medication usage, and
inform patients of side effects with medication administration. They need to make sure that they
are answering call lights within three minutes, addressing care needs, introducing each nurse
with bedside nursing report, and indicating the primary nurses names on the communication
board in patients room. Discharge teaching should begin upon admission and continue until
discharge.
Surveys are extremely important to improve patient satisfaction. Yoder-Wise states that
consumer satisfaction with healthcare can be assessed through the use of questionnaires,
interview, focus group discussions, or observations (2011, p.394). In current nursing practice,
rehabilitation centers utilize post discharge postal mail surveys and telephone surveys. Also, the
day after admission, nursing management meet and greet to identify patients needs or areas for
improvement in the quality of nursing care. Once all the data from the surveys is compiled in a
graph or chart, it can be utilized to initiate strategies to improve patient care and attend to patient
needs.
The meet and greet strategy for improved communication can be used to improve the
quality of healthcare services by actively listening to the patient, finding and addressing any
misconceptions or short comings in patient cares needs to ensure a positive experience, and
rewarding experience for the patient. Post discharge surveys via mail and telephone can be
utilized to find areas of improvement in meeting patient care needs. Patients in the HCAHPS
survey are asked if they felt they were listened to, if they felt nursing explained care in a way

LEADERSHIP STRATEGY ANALYSIS

they could understand and if they were treated courtesy and with respect, interventions such as
giving patient choices, and explain the use medications (HCAHPS, 2014). The organization can
reinforce opportunities to improve patient care by posting patient surveys in staff only areas,
such as in break rooms or conference rooms, as reminders to focus on current areas for
improvement. Daily staff huddles can be utilized to improve patient care areas at unit levels to
communicate areas for improvement that arise from nursing management meet and greet with
patients in their first few days in their stay.
Evaluation
Evaluating the outcome is necessary to make sure that improvements in the quality of
care are being made. The most proficient way to evaluate whether communication is increasing
from the nurse to the patient is through patient surveys. To evaluate this, surveys should be
introduced from the nurse to the patient. Through this process, the nurse will be able to explain
the importance of the patients opinion and participation in the survey. This may not only
increase patients completing surveys, but also increase satisfaction of nursing communication
because the nurses are communicating about the survey. This is a win-win situation for the staff
and patients.
Once the results of the surveys are gathered, it is important for management to review
them and find out what areas need to be worked on and/or what staff area is lacking. For

example, if the emergency room is lacking in their nursing communication to patient, it would be
important to target them to help them improve their communication. Management could tweak
this plan to work better for the emergency room in their area of weakness. Improving satisfaction
of the patients is a type of evidence-based practice to continue improving patient care. This is
extremely important for all staff members to realize.

LEADERSHIP STRATEGY ANALYSIS

Conclusion
Nursing communication is a vital part of improving patient care. Communication
throughout the healthcare field is the key to keep improving all aspects of the health field. The
staff must know what areas they are lacking into be able to improve their strategies to provide

the best possible care. Through surveys, communication issues can be addressed and the staff can
start making progress to fix their areas of weakness. Without communication, the system would
fall apart so it is vital to keep working on improving it.

LEADERSHIP STRATEGY ANALYSIS

References
Giordano, L. A., Elliott, M. N., Goldstein, E., Lehrman, W. G., & Spencer, P. A. (2009).
Development, implementation, and public reporting of the HCAHPS survey. Medical
Care Research and Review.
HCAHPS. (2014). Summary analysis. Retrieved from http://www.hcahpsonline.org/Summary
Analyses.aspx
Rochin, E. (2012). Healthcare reform and bariatric nursing: Exploring differences in patient
experience between bariatric and non-bariatric patients. Bariatric Nursing and Surgical
Patient Care, 7(1), p. 17-20. DOI: 10.1089/bar.2012.9998
Studer, Q., Robinson, B. C, & Cook, K. (2010). The HCAHPS handbook: Hardwire your
hospital for pay-for-performance success. Gulf Breeze, FL: Fire Starter Publishing.
Yoder-Wise, P. S. (2011). Leading and managing nursing (5th ed.). St. Louis, MO: Elsevier
Mosby.