Plan of this problem and restore healthcare organizations

Plan for Emphasizing Scholar-Leadership
among Healthcare Professionals

Summary

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There
is a dysfunction in communication between healthcare professionals and
non-medical administrative decision-makers. This gap has been shown to have
serious negative consequences for patient health outcome. It is herein proposed
that emphasizing the scholar-leader role of healthcare professionals, doctors,
nurses, and others at all levels, will alleviate much of this problem and
restore healthcare organizations to patient-centered mindsets as opposed to the
profit-centered mindset that has been the bane of healthcare professionals and
patients alike for the last several decades. This emphasis will begin among
healthcare professionals ourselves and then later expand to bring in
non-medical administrative decision-makers so as to reunify the different aspects
of healthcare organizational culture.

 

I. Introduction

The
purpose of this proposal is to demonstrate the need for scholar-leadership
among healthcare professionals and then how to integrate this capacity into
practice. This has become especially necessary as the need for healthcare
services is expanding in a population that is both growing and aging. Too
often, actual evidence-based policies and practices are ignored because of
administrative or budgetary concerns over which healthcare professionals have
little or no control. Thus, the need for scholar-leadership is largely in
response to the reality that many healthcare decisions today are made by people
with little or no medical training and need to be convinced that evidence-based
practices and policies are the best way to respond to patients’ needs.

II. Current Problems in Healthcare

There
are several major factors that have led to the current situation and it has
been developing for years. This has all contributed to negative patient health
outcomes as well as lowering respect for medical scholar-leaders among
healthcare administrators in terms of decision-making priorities.

a.    
The rise of the administrator in healthcare
decision-making has been remarked on for decades (Gray, 1983). Such decisions
affect staffing, scheduling, equipment purchases, hours of operation, and many
other critical factors in healthcare long before a medical professional ever
first meets their patients. Doing so from a dollars and cents perspective as
opposed to a patient needs perspective, that is, administrative versus medical,
has been shown to harm patient health outcomes. Ignoring these considerations
or downplaying their effects has a history of countering the positive effects
of evidence-based practice (Hajjaj, Salek, Basra, & Finlay, 2010).

b.    
Doctors, nurses, and other healthcare
professionals feel left out of the important decision-making processes, but
have been hesitant to speak in an environment where money seems to matter more
than life. Several have expressed their concerns, some publicly and some
anonymously, in various venues over the past several years and are extremely
concerned about the effects this situation is having on their patients (e.g.
O’Rourke, 2014). This is also not a new trend (Why, 1982).

c.    
The continued shortage of healthcare
professionals also affects this question (AAMC, 2016; AACN, 2017). Doctors and
nurses are often overworked to the point where they do not have time to both
help their patients in the immediate sense with regard to their health and work
to counter administrative policies that have negative effects on those same
patients. Without enough people available to make their voices heard,
healthcare professionals will continue to be ignored as bottom line decisions
are made without regard to human lives.

d.    
Administrative decision-making without regard to
actual patients has been shown to have serious negative consequences for
patient health outcome (Erickson, Rockwern, Koltov, & McLean, 2017). While
it is beneficial to patients to ease administrative burdens on healthcare
professionals, the divide between the two groups has become unsustainable.
Unfortunately, leadership training among doctors and other healthcare
professionals is a chronically ignored area of their training, both while in
school and during residency (Blumenthal, Bernard, Bohnen, & Bohmer, 2012).

III. The Need for Scholar Leadership

Despite
recent reports that the phrases “evidence-based” and “science-based” are no
longer welcome in certain areas of administration, these remain the gold
standards of healthcare practice (Rubin & Bellamy, 2012; Mole, 2017). The
gap in leadership among medical professionals is well known and much researched
but little has changed in recent years to alleviate this problem (Gray, 1983;
Blumenthal et al., 2012). Such leadership is impossible without evidence-based
information to reinforce its claim to legitimacy, both among fellow healthcare
professionals and to sway non-medical administrators to the view that it is
necessary (Rubin & Bellamy, 2012). It is uncertain if this is an
intentional oversight in training practices or if this is simply the result of
students and healthcare professionals being overwhelmed with their training or
workloads. In either case, the need is real and must be addressed.

IV. Proposed Solution

The
proposed solution is two-fold, with the steps and goals heavily interrelated:
Increase respect for scholar-leadership in healthcare professionals and
implement scholar-leadership into practice. The necessity and efficacy of evidence-based
practice must be emphasized in order to accomplish this task, both among
healthcare professionals and administrators. However, because doctors and
nurses alike are so often overburdened with patients’ needs, there may seem
like there is little time left in their days for outside research to improve
their practices (Hajjaj et al., 2010; O’Rourke, 2014; AAMC, 2016; AACN, 2017). Thus,
the first step is finding time for healthcare professionals to do this. The
best way to ease the current burden is to recruit, train, and hire more
healthcare professionals.

The
next major step is to amend healthcare professional training to include both
the importance of evidence-based practice and the skills to do so (Rubin &
Bellamy, 2012). Fortunately, organizations already exist with this precise goal
in mind, but they have yet to make any serious headway in terms of focus in
this field during the early stages of healthcare training and have concentrated
instead on those already in practice (ANIA, 2017). Groups like these
demonstrate that the value of scholarship is already appreciated among a
significant but not universal portion of the healthcare professional community.
In engaging with such organizations, it must always be emphasized that the
evidence-based practices that have been learned must also be used, whether in
direct dealings with patients or in interacting with administrators as they
make decisions that affect patient health outcome.

The
final step is in convincing the administrators. Given the profit-driven nature
of most healthcare organizations today, this will likely prove the most
difficult task. There are serious ethical considerations in such a structure
and healthcare professionals have noted it and considered it a threat to
patient welfare for decades (Gray, 1986). It should not be understood that any
such proposal will advocate for losing massive amounts of money. However, it
must insisted upon that the best decisions for healthcare provision must be
made and that they are more important than money. Here, it must be demonstrated
to administrators that evidence-based practice is the best route for successful
patient health outcomes and, in the long run, will actually reduce costs via
curtailing unnecessary or preventable emergency department visits, unplanned
hospital readmissions, and improving overall community health in general
(Study, 2013; AHRQ, 2017). That is, healthcare professionals must learn to
speak in the financial language understood by administrative decision-makers so
as to convince them of the necessity of making these changes which will benefit
both the patients and the healthcare organization’s overall financial health.

V. Implementation and Evaluation

It
will be my goal to implement the above program among colleagues and professional
organizations of which I am a member. This will require significant effort in
addition to my current medical practice, but it is worth it because the end
result will benefit the patients. The financial boon, a side benefit from my
perspective, will encourage non-medical administrative decision-makers to
assist me in these efforts. Quarterly and annual reviews of both financial
outcomes and from patient satisfaction surveys will be used as evaluation tools
(Al-Abri & Al-Balushi, 2014). In every stage, the need for
scholar-leadership among healthcare professionals is a first priority and
cannot be ignored.

VI. Conclusion

Too
often, actual evidence-based policies and practices are ignored because of
administrative or budgetary concerns over which healthcare professionals have
little or no control. Thus, the need for scholar-leadership is largely in
response to the reality that many healthcare decisions today are made by people
with little or no medical training and need to be convinced that evidence-based
practices and policies are the best way to respond to patients’ needs. The plan
outlined above will respond to these needs and gaps in current and future
healthcare practice.

 

References

Agency
for Healthcare Research and Quality. (2017). 30-day readmission rates to US
hospitals. AHRQ. Retrieved from https://www.hcup-us.ahrq.gov/reports/infographics/HCUP-hospital-readmission-infographic-final.pdf.

Al-Abri,
R., & Al-Balushi, A. (2014). Patient satisfaction survey as a tool toward
quality improvement. Oman Medical
Journal, 29(1), 3-7. http://dx.doi.org/10.5001/omj.2014.02.
 

American
Association of Colleges of Nursing. (2017, May 18). Nursing shortage fact
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American
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Erickson,
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Gray,
B. (Ed.). (1983). The new health care for
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Gray,
B. (Ed.). (1986). For-profit enterprise
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Hajjaj,
F., Salek, M., Basra, M., & Finlay, A. (2010). Non-clinical influences on
clinical decision-making: A major challenge to evidence-based practice. Journal of the Royal Society of Medicine,
103(5), 178-187. http://dx.doi.org/10.1258/jrsm.2010.100104.

Mole,
B. (2017, December 18). After firestorm, CDC director says terms like
“science-based” are not banned. Ars
Technica. Retrieved from https://arstechnica.com/science/2017/12/after-firestorm-cdc-director-says-terms-like-science-based-are-not-banned/.

O’Rourke,
M. (2014, November). Doctors tell all—and it’s bad. The Atlantic. Retrieved from https://www.theatlantic.com/magazine/archive/2014/11/doctors-tell-all-and-its-bad/380785/.

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Why
do doctors hate hospital administrators? (1982). Canadian Family Physician, 28, 527. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2306374/.