, reimbursement guidelines,
Is there a problem or need that I can address?
Is there an opportunity for quality improvement that I could lead?
Are there specific best practice standards of care that need to be instituted?
Are there specific regulatory guidelines for which compliance must be assured?
Are there expenses that could be diminished or contained?
Is there a health outcome that needs to be improved?
Is there a healthcare delivery process that needs to be enhanced?
Often these items are prime targets for planned change initiatives that will benefit the patient and the organization. Contact your mentor to discuss ideas you have, and they may have additional ideas to share. Collaborating with your course instructor, mentor, and the organization to determine the focus of your project creates a win-win situation for you, the organization, and all involved stakeholders.
How will you make a difference? How will you lead change in your corner of the world?
Assessment of the Problem
In order to investigate the organizational context and external factors impacting your selected problem, you will need to intentionally examine the following:
SWOT analysis of the organization (strengths, weaknesses, opportunities, and threats relevant to your planned change project)
Stakeholder involvement and support (identification of who is impacted by the problem, who will be impacted by the planned change, and strategies to engage these stakeholders to garner their input and support)
Financial implications of the problem and proposed planned change (present financial impact of the problem or need, cost of the change initiative, anticipated cost savings realized through the planned change, etc.)
External factors which drive or impact the problem (i.e., legislative mandates, health policy compliance, national quality directives, evidence-based standards of practice, accreditation requirements, external benchmarking, reimbursement guidelines, etc.) Note: Support from current professional publications and scholarly literature will be required to validate the external influencing factors.
As you consider each influencing factor, it is helpful to also consider the necessary assessment strategies for each element. Additionally, please note that the process of assessing internal and external influencing factors is iterative, rather than a ‘one-time’ task. As new evidence unfolds, or as stakeholder agendas change it is important to stay abreast of the elements, and relationships, which impact your project. There may be financial implications, regulatory, compliance, reimbursement, or accreditation factors relevant to your project that emerge over time. It will be important to maintain an ongoing assessment of these factors throughout your journey.
Strategies for Data Collection
Take a look at the data collection methods described below. How might you use these strategies to assess internal and external factors impacting the problem?
Influencing Factor
Strategies for Data Collection
SWOT Analysis
Internal assessment of the organization to determine the strengths, weaknesses, opportunities, and threats relevant to the problem and the planned change project
Review of organizational documentation regarding the problem
Key informant interviews with organizational leaders, team players, and other experts when necessary to define the SWOT
Stakeholder Involvement
Identification of all stakeholders who are affected by this problem or will be impacted by your planned change project
Consider stakeholders both internal and external to the organization (i.e., organizational departments, health care professionals from other disciplines, community members, patients, families, administration, etc.)
Develop strategies to engage stakeholders in order to solicit their feedback and perspective regarding the problem, and to garner their support of the planned change
Financial Implications
Information regarding this element will likely require discussion with the appropriate leader or health care administrator. Information to discover includes:
What is the present financial impact of the problem?
What are the anticipated costs involved with the planned change project?
What are the anticipated cost savings realized through the planned change?
External Factors
This element will likely require review of the literature, current best practices, related policies, etc. relevant to the problem or problem:
Legislative mandates
Health policy compliance
National quality or patient safety directives
Evidence-based standards of practice
Accreditation requirements
External benchmarking (such as HCAHPS, core measures, accountable care organizational practices, CMS guidelines, value-based purchasing, etc.)
Reimbursement guidelines
