D157: Managing Resources in an Era of Disruption
Human Resource Management
When assembling the project team for the planning and execution stages of the health information project (HIP), emphasis was placed on recruiting a varied group of professionals skilled in clinical, technical, and administrative areas to foster a well-rounded approach to achieving project goals. The planning phase featured a Chief Nursing Officer (CNO) to guide leadership and strategic direction, a Clinical Informatics Nurse Specialist to connect clinical processes with technology, and an IT Project Manager to oversee technical viability and adherence to timelines. These positions were selected to integrate leadership, clinical knowledge, and technical skills, facilitating the establishment of clear objectives and the creation of a solid plan. Each team member was anticipated to contribute insights from their respective fields, aiding in evidence-based decision-making and ensuring that the system’s design aligned with the organization’s objectives. D157: Managing Resources in an Era of Disruption
During the implementation phase, the team will be augmented with additional experts, including Nurse Educators, Unit Representatives from each department, and a Quality Improvement Analyst. The inclusion of Nurse Educators aims to facilitate effective training and encourage staff adoption of the new system, while Unit Representatives will offer valuable insights from the frontline to tailor the system to actual workflows. The Quality Improvement Analyst will play a vital role in tracking key performance indicators (KPIs) and ensuring that the system enhances both patient safety and operational efficiency. This carefully chosen implementation team is designed to guarantee a successful system rollout, comprehensive staff training, and smooth integration into everyday operations, thereby reducing potential disruptions.
Every team member has specific roles and responsibilities aligned with their areas of expertise. For instance, the Chief Nursing Officer (CNO) provides executive oversight, while the Clinical Informatics Nurse Specialist ensures that the system meets clinical requirements. The IT Project Manager is responsible for managing technical aspects. Nurse Educators focus on developing training resources and conducting workshops, whereas Unit Representatives are involved in testing the system and offering feedback. The Quality Improvement Analyst will track outcomes and address any discrepancies promptly. This diverse team will comprehensively manage the HIP project from its initial stages to full implementation.
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Project Team Member Engagement
Effectively leading a project team involves implementing various team-building techniques that enhance collaboration, build trust, and maintain accountability throughout the project’s duration. One essential technique is fostering team collaboration through regular interdisciplinary meetings, where members can review project milestones, share updates, and collectively tackle any challenges that arise (Mazzetti & Schaufeli, 2022). To cultivate trust, it is crucial to create open lines of communication, allowing team members to express concerns or offer feedback without fear of negative consequences. Additionally, incorporating coaching and mentoring will help ensure that all team members, especially those less familiar with health information technology, feel confident in their responsibilities. This strategy not only strengthens team cohesion but also aligns everyone with the project’s objectives, utilizing each individual’s strengths to drive collective success. D157: Managing Resources in an Era of Disruption
Team Management
Team guidelines play a crucial role in fostering organization and productivity. They establish clear communication expectations, utilizing standardized reporting tools and regular check-ins to promote transparency. Protocols for managing conflicts will be outlined to handle disagreements in a constructive manner, emphasizing discussions that focus on evidence-based solutions rather than individual viewpoints. The decision-making process will be designed to be collaborative, incorporating feedback from all team members, while project leaders retain the authority to make final decisions to align with strategic goals. These guidelines help maintain a smooth operational process and minimize disruptions, enabling the team to concentrate on achieving implementation goals.
Support for Team Members
Creating a supportive atmosphere for project team members and staff during the implementation phase is essential for fostering a healthy work environment. Implementing evidence-based strategies such as promoting psychological safety, ensuring access to necessary resources, and acknowledging achievements can significantly lower stress levels and boost job satisfaction. Studies indicate that having clearly defined roles and maintaining regular feedback can enhance engagement while reducing the risk of burnout (George & Massey, 2020). Additionally, encouraging flexible work schedules, providing mental health resources, and preventing overwhelming workloads contribute to a better work-life balance. Research indicates that effectively managing both professional and personal responsibilities leads to increased productivity and improved job retention. These initiatives help cultivate an environment where staff feel appreciated and empowered throughout the project’s execution.
Financial Resource Management
Financial forecasting played a crucial role in creating the Pro Forma Operating Budget for the Healthcare Improvement Project (HIP), allowing for precise cost estimations that support the project’s viability and long-term success. This involved a thorough examination of past financial performance from comparable projects, forecasting future developments, and assessing expected resource requirements. For personnel expenses, calculations for salaries, overtime, and benefits for both existing team members and new hires were based on current pay scales and anticipated workloads. Non-personnel costs, such as expenses for technology purchases, training resources, consulting fees, and reserve funds, were established using vendor estimates, industry standards, and previous spending trends. This comprehensive strategy ensured that all financial aspects of the project were addressed while minimizing unnecessary costs.
The decision to include contingency funds was based on financial projections that considered possible fluctuations in expenses, which ensured that the project would not encounter funding shortfalls. This strategy effectively managed uncertainties, including unforeseen technology expenses or extra training requirements. The project was able to uphold fiscal responsibility while providing the essential resources needed for successful execution by striking a balance between strategic investments and cost management. D157: Managing Resources in an Era of Disruption
The control phase of implementing the HIP requires thorough oversight of both the operating budget and the project’s advancement to maintain alignment with established objectives. Monthly budget reviews will be conducted through variance analysis, which involves comparing actual spending to the planned budget. If any variances exceed 10% of the expected figures, an immediate investigation will be initiated, leading to corrective measures such as reallocating resources or modifying timelines. For instance, if the costs for training materials rise due to a larger number of staff participating, adjustments will be made by optimizing the distribution of materials or utilizing digital tools.
Additionally, timelines and schedules will be meticulously monitored using project management software to ensure compliance with the Systems Development Life Cycle (SDLC). Throughout the implementation phase, critical milestones—such as system testing and staff training—will be reviewed on a weekly basis to avoid any potential delays. Progress reports will be disseminated to stakeholders, promoting transparency and encouraging accountability among team members. These strategies work together to enhance the project’s success by ensuring that both financial and operational elements are in sync.
Budget Variances
Monitoring and addressing budget variances is essential for maintaining financial oversight and ensuring the success of the Healthcare Improvement Project (HIP). Variances arise when actual expenditures differ from the planned budget, necessitating systematic tracking and swift action. Monthly financial reviews will be held to compare the projected budget against actual spending reports. Any discrepancies will be recorded and classified as favorable (indicating cost savings) or unfavorable (indicating overspending), followed by an analysis to uncover the underlying causes.
Financial management tools such as MS Excel spreadsheets will be utilized to offer comprehensive insights into spending categories to monitor variances effectively. These tools will produce variance reports that spotlight areas exceeding established thresholds, such as a 10% deviation. A traffic light system will be employed to prioritize issues, with green indicating on-target performance, yellow for minor variances, and red for significant discrepancies. The project manager will collaborate closely with the finance team and department leaders to assess how these variances affect overall project goals and to determine appropriate corrective actions.
Addressing variances requires a blend of preventive and corrective approaches. Preventive strategies include accurate initial forecasting, maintaining a contingency fund, and enforcing strict approval processes for unforeseen expenses. For unfavorable variances, corrective measures may involve reallocating resources, cutting non-essential expenditures, or negotiating cost adjustments with suppliers. In the case of favorable variances, the project team will evaluate whether to reinvest the savings to improve project outcomes or to set them aside for other organizational priorities.
Effective management of variances relies heavily on communication and engagement with stakeholders. The leadership team and pertinent stakeholders will receive consistent financial status updates and explanations for variances. This level of transparency builds trust, encourages collaborative solutions, and ensures that financial issues are tackled proactively while maintaining the project’s scope, quality, and timeline.
Project Charter
The Healthcare Improvement Project Charter is designed to tackle the challenge of limited patient mobility in acute care environments by utilizing the Johns Hopkins Mobility Tools and Resources. The initiative aims to enhance patient mobility through comprehensive staff training, thorough mobility assessments, and effective patient education. The targets include a 20% increase in mobility levels, a 15% rise in discharge-to-home rates, and a 10% reduction in length of stay over a six-month period, specifically from October 1, 2024, to March 31, 2025. Potential challenges such as staff pushback, limited resources, and patient hesitance will be addressed through careful planning and implementation, including a detailed timeline featuring key milestones. The project’s success will be evaluated based on achieving a 90% completion rate for training, ensuring that 95% of patients undergo daily mobility assessments, and decreasing the duration of hospital stays. D157: Managing Resources in an Era of Disruption
D157 Task 1 Healthcare Improvement Project Charter
Justification
The project is being implanted to tackle the significant problem of insufficient patient mobility in acute care environments. Mobility plays a crucial role in the recovery process, and many patients’ inability to regain full mobility results in prolonged hospital stays and higher healthcare expenses. A needs assessment revealed that 58.9% of patients who are physically capable do not achieve sufficient mobility during their hospital stay, which adversely affects both patient outcomes and the allocation of healthcare resources. This project intends to adopt the Johns Hopkins Mobility Tools and Resources (McLaughlin et al., 2023), emphasizing early and consistent mobilization, staff training, patient education, and the utilization of mobility technicians to facilitate safer and more effective patient ambulation. This strategy is expected to lead to quicker discharges, enhanced health outcomes, and a decrease in overall healthcare costs.
Purpose of the Project
This initiative aims to enhance patient mobility by employing a systematic, evidence-driven strategy that utilizes the Johns Hopkins Mobility Tools and Resources. Integrating daily assessments and interventions focused on mobility, the project aims to boost staff involvement, optimize workflows, and tackle challenges like patient hesitance, limited staff availability, and coordination issues. The rollout of this mobility protocol is designed to raise the number of mobility assessments conducted, offer straightforward guidelines for staff, and improve patient education, which will lead to better patient outcomes, reduced hospital stays, and faster recovery times.
Significant Risks
| Risks | [What are the most significant risks?] |
| Change resistance from staff | Nurses and mobility technicians might oppose modifications to their established workflows or training methods. |
| Resource depletion | Resource constraints could pose challenges, with potential shortages in personnel or funding necessary for training, mobility aids, or technician roles. |
| Patient safety risks | There is a risk of falls or injuries during mobilization, especially if patients are not adequately prepared for physical activity. |
| Poor patient involvement | Patient reluctance may also be an issue, as some individuals might feel anxious about moving or may be unwilling to participate in mobility interventions, which could diminish the program’s overall effectiveness. |
Project Budget
The project budget is structured as follows: Personnel costs amount to US$120,000, which includes expenses for staff training for nursing, physiotherapy, and mobility technicians, as well as the hiring of mobility technicians. Non-personnel costs total US$65,500, covering mobility aids and equipment, patient education materials, administrative expenses, and implementation costs, with a contingency fund of US$18,850 allocated for unforeseen expenses. The total projected budget is US$204,050. D157: Managing Resources in an Era of Disruption
Project Timeline
The project timeline consists of several key milestones. The first milestone begins on October 1, 2024, focusing on project initiation and needs assessment, which involves meetings with stakeholders and the allocation of necessary resources. The second milestone is set for December 31, 2024, marking the midpoint of the project. During this phase, the full implementation of training, mobilization protocols, and patient education campaigns will take place, along with the first review of the project’s progress in relation to its goals, such as training completion and the frequency of mobility assessments. The final milestone concludes on March 31, 2025, with a comprehensive evaluation that will assess mobility improvements, discharge-to-home rates, and reductions in length of stay. This phase will also include the preparation of a final report and recommendations for the project’s sustainability.
References
George, V., & Massey, L. (2020). Proactive strategy to improve staff engagement. Nurse Leader, 18(6), 532–535. https://doi.org/10.1016/j.mnl.2020.08.008
Mani, H., Möri, C., Mattmann, M., Liechti, F., Inauen, J., Aujesky, D., Donzé, J., & Aubert, C. E. (2022). Barriers and facilitators to the mobility of patients hospitalized on an acute medical ward: a systematic review. Age and Ageing, 51(7). https://doi.org/10.1093/ageing/afac159
Mazzetti, G., & Schaufeli, W. B. (2022). The impact of engaging leadership on employee engagement and team effectiveness: A longitudinal, multi-level study on the mediating role of personal- and team resources. PloS One, 17(6), e0269433. https://doi.org/10.1371/journal.pone.0269433
McLaughlin, K. H., Friedman, M., Hoyer, E. H., Kudchadkar, S., Flanagan, E., Klein, L., Daley, K., Lavezza, A., Schechter, N., Young, D., & JH-AMP Group. (2023). The Johns Hopkins Activity and Mobility Promotion Program: A framework to increase activity and mobility among hospitalized patients. Journal of Nursing Care Quality, 38(2), 164–170. https://doi.org/10.1097/NCQ.0000000000000678
Patel, S. V., Imburgio, S., Johal, A. S., Ramirez, C., DiSandro, K., Mathur, D., Walch, B., Buccellato, V., Hossain, M. A., & Asif, A. (2023). Improving discharge rates to home with the help of mobility technicians: A step in the right direction. Cureus, 15(11), e48298. https://doi.org/10.7759/cureus.48298
Schafthuizen, L., van Dijk, M., van Rosmalen, J., & Ista, E. (2024). Mobility level and factors affecting mobility status in hospitalized patients admitted in single-occupancy patient rooms. BMC Nursing, 23(1), 11. https://doi.org/10.1186/s12912-023-01648-4
Appendix A
SMART Goal Worksheet (D156)
| SMART
Questions |
SMART
Answers |
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| Specific:
· What is your project? (Be specific) · How will you accomplish this? (interventions) |
What is your project?
The project aims to improve patient mobility in acute care settings using Johns Hopkins Mobility Tools and Resources. This involves assessing current mobility levels, identifying barriers and facilitators, and implementing targeted interventions to enhance patient mobility. How will you accomplish this? The project will be implemented through: · Assessment: Evaluating current mobility levels and identifying barriers based on existing literature and data. · Intervention: Introducing Johns-Hopkins Mobility Tools and Resources, including mobility protocols and staff training. D157: Managing Resources in an Era of Disruption · Evaluation: Monitoring mobility improvements through regular assessments and patient feedback. |
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| Measurable:
· What will you measure to determine your project’s success? (Indicators or metrics) · How will you know that change has occurred? · What percentage of the outcome will you accomplish by date? (Numbers and quantities provide means of measurement and comparison). |
What will you measure to determine your project’s success? Success will be measured using:
· Mobility Levels: Improvement in patient mobility levels, assessed through the Johns Hopkins Highest Level of Mobility Scale (JH-HLM) and EQ-5D-3L. · Patient Discharge Rates: Increased percentage of patients discharged to home. · Length of Stay: Reduction in hospital length of stay. · Patient Satisfaction: Enhanced patient satisfaction scores related to mobility and overall care. How will you know that change has occurred? Changes will be identified by: · Comparative Analysis: Comparing pre- and post-intervention mobility levels, discharge rates, and length of stay. · Statistical Significance: Analyzing data for statistically significant improvements. What percentage of the outcome will you accomplish, by date? · Mobility Levels: Aim for a 20% improvement in patient mobility scores within 6 months. · Discharge Rates: Increase discharge-to-home rates by 15% over 6 months. · Length of Stay: Achieve a 10% reduction in length of stay within 6 months. |
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| Achievable:
· Based on your impact analysis and SWOT analysis, what support, resources, and justification exist for your project? |
Support, Resources, and Justification:
· Barriers and Facilitators: Studies have identified barriers such as patient characteristics, lack of time, and environmental factors (Mani et al., 2022). Facilitators include knowledge of mobility importance and interdisciplinary support (Herzog et al., 2023). By addressing these factors, the project can realistically achieve its objectives. · Resources: The project will utilize Johns Hopkins Mobility Tools, staff training programs, and patient engagement strategies. |
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| Relevant:
· Is your project worthwhile? · Why does your project matter to the target population, the organization, and nursing practice? |
Is your project worthwhile? Improving patient mobility is crucial for reducing hospital-acquired complications and optimizing resource use. Studies show that early ambulation improves clinical outcomes and reduces hospital length of stay (Patel et al., 2023; Schafthuizen et al., 2024). The project aligns with these findings, demonstrating its relevance to patient care and organizational efficiency.
Why does your project matter to the target population, the organization, and nursing practice? · Target Population: Enhances patient outcomes and quality of life by improving mobility. · Organization: Reduces hospital length of stay and associated costs, improving operational efficiency. · Nursing Practice: Empowers nursing staff with tools and protocols to better support patient mobility, aligning with best practices. D157: Managing Resources in an Era of Disruption The SWOT Analysis revealed strengths such as strong interdisciplinary support and staff enthusiasm for improving patient care, while weaknesses included time constraints and varying levels of staff experience with mobility protocols. The Impact Analysis indicated that successful implementation of this project could lead to significant reductions in adverse events related to immobility and an overall enhancement in patient satisfaction and outcomes. These insights underscore the relevance of the project to improve both clinical practice and patient experiences in acute care settings. |
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| Time-Bound:
Include these dates: · Health Placement Approval date · D156 course start date · project start date · project end date · expected graduation date Your project start date must be after the health placement approval date and D156 start dates. For an implementation project, your project end date must be before your expected graduation date. For an approved modified clinical activity project your end date must be after your graduation date.
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Time-Bound:
· Health Placement Approval Date: March 4, 2024 · D156 Course Start Date: August 5, 2024 · Project Start Date: October 1, 2024 · Project End Date: March 31, 2025 · Expected Graduation Date: July 31, 2025 |
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| SMART Project Goal: Synthesize your SMART answers from above into a statement that includes the specific, measurable, and time-bound elements. | ||||||
To improve patient mobility in acute care settings by implementing Johns-Hopkins Mobility Tools and Resources, aiming for a 20% improvement in mobility levels, a 15% increase in discharge-to-home rates, and a 10% reduction in length of stay within 6 months, starting from October 1, 2024, to March 31, 2025.
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| KPI # 2
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KPI #2: Patient Mobility Assessment Frequency
Description: The frequency of mobility assessments conducted using the Johns Hopkins Highest Level of Mobility Scale (JH-HLM) for each patient. Target: Ensure that 95% of patients have their mobility levels assessed daily throughout the project duration (from October 1, 2024, to March 31, 2025). Justification: Regular assessments are crucial to monitor progress and adjust interventions as needed. Consistent documentation of mobility levels will provide data to track improvements and identify areas needing additional support, contributing to achieving the overall project goals. D157: Managing Resources in an Era of Disruption |
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Appendix B
Healthcare Improvement Project
RACI Chart
| HIP Tasks/Deliverables (Minimum of Five) | Project Team Members | ||||||
| Project Manager (RN) | Nursing Staff Rep(s) (RN) | Physiotherapist (PT) | Nursing Manager (MSN, RN) | Mobility Technician Team Rep (CNA) | Data Analyst | ||
| Developing a detailed project plan | A,R | C | I | C | I | C , I | |
| Implementing mobility protocols | A | R | C | I | R | I | |
| Training nursing staff on mobility techniques | R , C | A , R | C | C | R | I | |
| Collecting and analyzing patient mobility data | R , I | C | I | I | C | A , R | |
| Reporting progress and outcomes to stakeholders | A , R | I | I | I | I | R , C | |
| In the empty boxes above, enter the appropriate letter for the role that will be responsible, accountable, consulted, or informed for each deliverable/task using the following letters: | |||||||
| R = responsible for completion of task or deliverable (at least one person per task should be responsible)
A = accountable for completion and approval of the task (at least one person per task should be accountable) C = consulted by those responsible for advice and expertise I = informed and updated on progress, notified when tasks are completed |
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Appendix C
Healthcare Improvement Project
Pro Forma Operating Budget D157: Managing Resources in an Era of Disruption
| Budget Category | Budget Item (Minimum of Five) | Budget Amount
(in US $) |
Comments
(as needed) |
| Personnel | 1. Team salaries and benefits | 14,070 | This amount covers base salaries, overtime pay, and benefits for the project team and additional personnel. |
| Non-Personnel | 1. IT System Acquisition | 50,000.00 | Allocated for the purchase and installation of essential healthcare IT systems needed for the project |
| 2. Educational Resources | 1,000.00 | Allocation for the creation and distribution of training manuals, videos, and learning modules for all employees | |
| 3. Consultant Fees | 5,500.00 | Payment for external consultants who will offer expertise in customizing and implementing the IT systems. | |
| 4. Subscription Fees and Licensing Fees | 5,000.00 | Allocated for software and system subscription and licensing services for the duration of the project. | |
| Total: | $ 75,570.00 D157: Managing Resources in an Era of Disruption |
