The Barnes Jewish Hospital is Missouri's largest modern, state-of-the-art private hospital, hosting students from the Washington University School of Medicine. It is located in St. Louis and has been regularly regarded as a high-quality institution in terms of Medicare and the professionalism of its staff members. Many rating organizations have lauded its level of health care services, making it one of the most favored healthcare institutions in Missouri and the United States as a whole. Barnes Jewish Hospital, being a competent healthcare institution, has numerous clinical sections with personnel that are best prepared to provide medical care to patients. The mission of the clinical section is to offer exceptional patient care, provide quality medical knowledge to students and other practitioners as well as ensure that the uninsured community within and outside the state of Missouri receive medical attention at a reduced cost.
The clinical areas provide a wide range of services key among them being a diagnosis, treatment as well as rehabilitation for individuals addicted to various medical problems. The clinics also offer a wide variety of surgeries that are conducted based on the level of attention required by a patient. The hospital ensures that every patient receives their due treatment regardless of the gender, age, race, socioeconomic status or background. It provides an equal opportunity environment to all who require medical attention. Zeller, Lind, Xia, Koleva, & Safah, (2017) noted that the hospital’s clinic area has several segments each dealing with specific medical requirements. These clinical areas include the Surgical and Wound Care Clinic (Floor 3, Suite 340), Specialty Care Clinic (Floor 4, Suite 420), Pulmonary Clinic (Floor 4, Suite 420), Psychiatric Clinic (Floor 4, Suite 441), Primary Care Medical Clinic (Floor 2, Suite 241), Obstetrics and Gynecology Clinic (Floor 3, Suite 341), Neurology (Floor 4, Suite 420) and Dermatology (Floor 4, Suite 420). In this discussion, we shall discuss in detail the Obstetrics and Gynecology Clinic commonly referred to as the OB-GYN Clinic. As the name implies, the clinic is specialized in serving women from all walks of life who may require gynecological advice, among other forms of treatments.
The clinic is spacious with more than 500-bed capacity to accommodate in-patient women who may require advanced care from the highly professional staff. Most of the services provided in this clinic are supervised by the Washington University School of Medicine most of who are practicing doctors and nurses at the Barnes Jewish Hospital. The types of patients referred to this clinical unit are adult women in need of healthcare services such as blood drawing, ultrasound, birth control and family planning, pregnancy tests, evaluation of abnormal PAP smears among others (Sledge, Potter, & Stapleton, 2016). Female minors are usually referred to the main hospital facility to be checked on by a pediatrician for problems ranging from gynecological problems to obstetrical care. This unit has the highest number of nurses than any other in the hospital given the intensity of care administered as well as the conditions of the patients involved. The clinic is designed to accommodate a large number of patients both inside and outside given that it is situated across the Center for Advanced Medicine that adequately offers a quicker and more flexible access from the clinical segment. The unit operates under close surveillance of professionals from the radiology, nutrition/dietetics, pharmaceutical, social services and diagnostic laboratories departments. This ensures that every shift during the daily working hours adequately meets the demands of every patient hence, the higher number of nurses per shift.
Enforcement of the American Association of Critical-Care Nurses (AACN) Standards
The hospital’s OB-GYN clinic has effectively applied the AACN Standards for the delivery of key services to the clientele. The AACN Standards has six elements that should always be observed by a healthcare facility failure of which it risks poor grading and hence negative publicity. The elements as having been applied by the hospital’s unit comprise effective decision making, skilled communication, meaningful recognition, true collaboration, appropriate staffing, and authentic leadership. The OB-GYN clinic has been praised in several quarters for maintaining an effective and smooth communication pattern between and among patients and healthcare providers. That every individual within this unit has an opportunity to air out their views concerning the care given, the conditions of the clinic and any other information that may be detrimental to the affairs of the clinic and the entire hospital. One can easily notice the professional engagement between the nurses, doctors and the ancillary staff, an aspect that attracts high patient traffic. The humane environment at the facility has been vigorously grounded on the basis of an open and transparent communication between the concerned parties. Privacy is also highly regarded in this facility. The information shared between a patient, and the respective nurse or doctor is treated with utmost secrecy unless the patient gives the doctor consent to share such. This form of communication and respect to each party’s rights while at the clinic makes the OB-GYN center a go-zone to many financially able and challenged patients. Additionally, the families of the concerned patients are also brought into the picture after consultations with the respective patient. They are made to know how such a patient is faring on at a private area made specifically for such a purpose. Hence, the OB-GYN clinic is regarded as one of the best centers in the hospital. In case of any form of disruption, the security personnel is brought into the scene to practice their professionalism in handling matters crisis. This additional resource is critical in completing the cycle of effective and efficient communication within the institution.
On the other hand, the second AACN standard of True Collaboration between the unit and others within and outside the hospital is highly observed. That cooperation is always encouraged between the team members to ensure that their goals and expectations of their respective patients are always met. There has been a collaboration between the clinic and other neighboring healthcare providers, pharmacies, and institutions to help identify and solve the growing concerns facing women and children. This collaboration has ensured that the OB-GYN section of the Barnes Jewish Hospital remains one of the most preferred centers for health-related complications in the state of Missouri. In relation to this, the AACN Standards also require that in addition to effective and true collaboration, an institution should be able to effectively make proper decisions which are aligned with its objectives, goals, mission, and vision. The OB-GYN clinic observes this standard by creating an environment that accommodates all forms of decisions from every member of its fraternity. That the nurses, graduate doctors from the Washington University School of Medicine, ancillary staff and the senior medical and even the patients are all involved in decision making especially on matters pertaining the clinic. Such an environment has enhanced the relationships between the parties to the level that it becomes easier for the entire management to run the institution. Potter, Deshields, & Rodriguez (2013) unanimously agreed that the fact that each of the clinic’s staff is entitled to their opinion and that they will be held accountable for their decisions is also another benchmark for decision-making. In many institutions offering health care services, the low-grade employees such as nurses are rarely present in the decision-making table. However, at the OB-GYN clinic of the Barnes Jewish Hospital, such individuals are given priority especially on such matters since they are the key players interacting with the patients who are the sole customers of the institution. Their opinion on any given matter pertaining the hospital or any other segment is usually given priority, hence a reason for the high ranking of the hospital globally.
Appropriate staffing is also another key element of the AACN Standards. The clinic observes this requirement by ensuring that each ward is adequately staffed on a daily basis and that each patient is on due care at each time of the day/night (Zeller, Lind, Xia, Koleva, & Safah, 2017). As alluded to above, the number and competency of the staff are determined by the Washington University School of Medicine. This means that at every given time, there is a routine schedule that is well observed by all the nurses to ensure that no gap is felt by any of the patients within. In the event of emergencies, a hotline has been provided that is responsive based on the magnitude of the case as well as the conditions of the patients involved. In the event of any requirement within the clinic, a clinic phone number is also provided, all for the benefit of both the patient and the institution. The nurses are also made available during the weekends, holidays as well as off-peak hours and the hospital, through the clinic, ensured that all are adequately remunerated. The nurses enjoy a lot of support from the hospital in the forms of frequent training and development services, registration to the state of Missouri Medical Union, free health care services among other utilities, a tremendous way to boost employee morale at the workplace (Barnes, & Lefton, 2013). In the event of good performance, the clinic observes this AACN Standards through an annual performance measurement scheme that evaluates each of the employees. Hence competition to receive some of these auspicious awards is high all through the year, and those who succeed are well rewarded. The clinic has various segments along which to award the nurses and doctors based on an individual, group or overall. However, this area has not been effectively actualized in the recent past and many of the nurses and doctors who work hard cite a lot of favoritism regarding recognition.
The management of the clinic and the hospital at large embrace the imperative of working in a healthy environment. Through this, they have ensured that democracy prevails all through the systems of the clinic from top to bottom. Whyte, McAlister, Mumm, & Shaw, (2015) posit that the unit manager is constantly working to ensure that no one feels rejected for a reason or another. These democratic principles have proven to work effectively when it comes to decision-making. Individual nurses are meant to take up leadership roles whenever their bosses are out of duty. The unit manager has also divided the nurses into teams that are led by their fellow practicing nurses, a move that permeates throughout the hospital. This form of democracy is highly enjoyed by those who work in this institution since they are given an opportunity to practice every aspect of their abilities. A rare spectacle! Nevertheless, this kind of power democratically given to subordinates is immune to abuse since many organizations have frequently been rocked by both the intra and intergroup conflicts. A tradeoff between the management and the groups within the system should be based on the fact that both parties agree on the powers and responsibilities vested upon each one of them.
Summary Evaluation
The overall working condition at the Barnes Jewish Hospital’s OB-GYN unit is conducive given the status enjoyed by the institution, especially from the society. Most of the clinic’s operations are pegged on the AACN Standards save for a few areas that require additional attention and resources. The facility’s strongest areas are in terms of how well information flows within and around; the democratic leadership approach assumed by its management; decision-making based on collective agreement as well as competent staff consisting of practicing doctors; ancillary staff as well as a large pool of students from the Washington University (Whyte, McAlister, Mumm, & Shaw, 2015). However, a few areas that require management attention include the approach by some of the nurses especially on the evening, night and holiday duties, intergroup conflicts that have recently and frequently been reported at the institution as well as the high costs of medication given the hospital’s status. These are some of the areas that, if not urgently corrected, could lead to massive shock waves from within and outside hence lowering the overall grading of the hospital and subsequent reputation. If I were assigned to serve as a CNL in this unit, I would highly encourage the aspect of communication especially from the public who have varying perceptions about the institution. Additionally, I would ensure that the number of groups within the clinic’s nursing fraternity is substantially reduced to exercise maximum control over the nurses and other employees. Regardless of the fact that they are professionals, I will encourage higher levels of competition by introducing work-related incentives that require each to reach a given level of productivity for promotions or otherwise. Above all, I will work harder to ensure that the mission, vision, and objectives set forth by the hospital and especially the OB-GYN section are attained to their fullest.
References
Barnes, B., & Lefton, C. (2013). The power of meaningful recognition in a healthy work environment. AACN Advanced Critical Care,24(2), 114-116
Potter, P., Deshields, T., & Rodriguez, S. (2013). Developing a systemic program for compassion fatigue. Nursing administration quarterly, 37 (4), 326-332.
Sledge, J. A., Potter, P., & Stapleton, P. (2016). Participant Voices: Making a Nurse Residency Program Better. Nurse Leader,14(5), 358-364
Whyte, M. P., Madson, K. L., McAlister, W. H., Mumm, S., Novack, D. V., Blair, J. C., & Shaw, N. J. (2015). Response to: A Rapid Skeletal Turnover in Radiographic Mimic of Osteopetrosis Might Be Secondary to Systemic Mastocytosis. Journal of Bone and Mineral Research, 30(5), 946-946
Zeller, M. P., Lind, K. D., Xia, X., Koleva, Y. N., & Safah, H. (2017). Program Process Improvement: Identification of Apheresis Staff Hire and Training Needs to Maintain BMT Quality Metrics, Patient Safety, and Product Quality. Biology of Blood and Marrow Transplantation, 23(3), S454-S455
