Two Separate Levels of Governance at a Teaching Hospital Essay Example for Free

Two Separate Levels of Governance at a Teaching Hospital Essay Dr. Darrick Kent (2007) is an assistant professor of family medicine, director of curriculum and head of medical information systems at a teaching hospital with a popular residency training program.   The hospital has two hundred and seventy beds with faculty and residents making approximately five hundred and sixty bedside patient visits every week.   According to Dr. Kent, the organizational size of his hospital – with approximately two hundred and ten people working on different shifts during each month – is substantial enough for him to try out new methods of governance as in charge of the medical information systems.    In other words, he would like to ease the governance of the facility by all means with the use of latest technology. As an example, Dr. Kent has introduced the Personal Digital Assistant (PDA) to all members of the faculty as well as residents at the hospital.   According to him, it was necessary to introduce the PDA to the residents and faculty members across the facility.   He knew that his â€Å"colleagues† would benefit from the PDA that makes it easier for everybody to communicate across the facility, and is also loaded with trusted references (Kent).   Because of his decision, the facility is currently using its annual budget for electronic medical references from Skyscrape Inc.   These references are the same as the actual books written by some of the world’s best medical authors and sold by top medical publishers (Kent).   Ã‚  Ã‚  Ã‚   Throughout his day at the teaching hospital, Dr. Kent is approached by his colleagues with a variety of questions, not only about medical information systems but also about the medical practice in general.   Especially in times of emergency, Dr. Kent is considered a ready reference for information about drugs as well as diseases.   Despite the PDA in everybody’s palm, Dr. Kent is considered by his colleagues as a superior authority on medical information â€Å"because of the nervousness felt by the new doctors and nurses† at the facility (Kent).   Still excited about the PDA, which was introduced at the facility in 2005, he explained this part of his job with an example:   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The other day I was presented with a case of myocardial infarction by way of calls received from the emergency room physicians in order to review a patient.   With my PDA in hand, I did not have to go to my office and open up the Griffith’s 5-Minute Clinical Consultant before checking its index.   Instead, I simply typed ‘MYO’ on my PDA and got all the information required to send back to the emergency room physicians in the matter of moments.   Ã‚  Ã‚  At present, Dr. Kent is seriously considering the introduction of nursing informatics at the facility.   According to him, nursing is a scientific discipline with a focus on information or knowledge.   Hence, nursing informatics, too, is focused on the easy access of crucial information to nurses.   Indeed, nursing informatics has the power to embrace all pieces of information that a nurse would require at any time. Whether it is patient data or information about medicines that is required by a nurse at any given time, the help that information technology can provide in accessing required information cannot be discounted.   With Dr. Kent’s decision to install appropriate nursing informatics at the facility, nurses would no longer have to flip through â€Å"book after book† to find needed information at a time of emergency (Kent).   No longer would they have to go searching for doctors either (Kent).   Ã‚  Ã‚  Ã‚   Also according to Dr. Kent, everybody is considered a colleague at his facility.   Even the nurses are nowadays enjoying the concept of â€Å"shared governance† in practice (Kent).   Linda Chavez (2007), an acute care nurse at the same facility confirmed Dr. Kent’s report on shared governance for the nurses.   She has worked with the teaching hospital for thirteen years.   Now a teaching nurse (for acute care) at the healthcare facility, Ms. Chavez is thrilled about Dr. Kent’s decision to install nursing informatics which would make her job much easier. She has little part to play in this decision of Dr. Kent or other senior members of the hospital.   Still, she has recently joined a council group at the hospital with nurses and other members of the facility making joint decisions that usually have a dramatic impact on the quality of patient care.   The council group has already been consulted about the introduction of nursing informatics at the facility.   However, â€Å"the final decision rests with Dr. Kent,† Ms. Chavez explained.   Ã‚  Ã‚  Ã‚   The council group considers all of its members as equals.   Nevertheless, the seniority of the directors of the facility remains unperturbed.   Moreover, everybody at the facility is not invited to become a member of the group.   â€Å"The final decision about the group members rests on the directors of the facility, and they are allowed to remove anybody from the group at whatever time they will† (Chavez).    The council group that Ms. Chavez joined in late 2006 is responsible for evaluating the status quo, besides recommending changes that the members deem necessary.   Nevertheless, she emphasized that her role in governance is strictly restricted to â€Å"recommendations† (Chavez).   Ã‚  Ã‚  Ã‚   Ms. Chavez is grateful that nurses may now join the council group upon invitation at the facility.   The concept was first introduced at the hospital in the year 2005.   Ms. Chavez explained the importance of nurses joining the council group thus:   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Back in 2005, some of the nurses in the council group complained about Coumadin, a blood thinner that many of the patients at the facility were administered.   Seeing that changes in blood consistency often put patients at risk of fatal bleeding or clotting, and we had no procedure in place for determining how regularly patients should return to get their blood tested; this issue raised by nurses was an extremely important one.   So, the council decided to Two Separate Levels of Governance at a Teaching Hospital  address it once and for all.   There was extensive research conducted, after which the hospital  issued new guidelines based on the findings of other council members. For Ms. Chavez and the other nurses that are currently a part of the council group, it is invigorating to join hands with the physicians in implementing important changes across the facility.   Even so, directors such as Dr. Kent have â€Å"the upper hand† (Chavez).   Also according to Ms. Chavez, nurses have always taken their limited role in the governance of a healthcare facility for granted. Although the council group is â€Å"a breath of fresh air,† most of the nurses at the facility are not allowed to join it yet (Chavez).   Because the facility where Dr. Kent and Ms. Chavez work â€Å"would always be a teaching hospital,† the directors are considered authority figures and physicians rarely are (Chavez).   All the same, both interviewees remain generally satisfied with their particular levels of governance (Chavez Kent). References Chavez, L. (2007). Personal Interview. Kent, D. (2007). Personal Interview.