Week 5: Organizational Culture and Climate on Group Process and Team Building
Individual:
You are the unit director of the emergency department and part of an ad hoc interdisciplinary committee newly formed to address a 30% rise in arrival-to- provider time over the past six months. Six months ago, the ED consistently recorded an arrival-to-provider time less than the national benchmark of twenty minutes. The arrival-to-provider time is presently over one hour. A root cause analysis study finds that arrivals to the ER have increased by 50% and the lobby is usually filled to capacity. Often patients must stand due to lack of adequate seating. FTEs have not been added and staffing is consistently short due to call-offs. Patients are not being discharged from inpatient beds in a timely manner. The task for the committee is to propose a solution for the problem.
1. Looking at this through the lens of an evidence-based quality improvement process, what would you propose as the PICOT for this initiative?
2. Who are the stakeholders represented in your group? (Remember, this is an internal organizational issue, and while patients are impacted by the issue and are the beneficiaries of the work done, they would not be included in this type of task force)
(for your review, see the example for developing a PICOT below or refer to the Nurse Executive Track CGE Academy webinar located in resources and announcements)
Group:
1. Discuss how the perspectives for the PICOT differ depending on the discipline represented by each stakeholder?
2. What impact will they have on the group process and in team building?
3. How is the group process and team building effected by the organization’s culture and climate of transparency and safety?
4. How will the outcomes of the committee be impacted?
PICOT Writing Review
Situation:
Sunnybrook Health System has started the process for acquiring Magnet status. They have scheduled multiple planning and process meetings over the next year that require attendance of all staff. Staff must attend at least 70% of the meetings live. After three meetings, live attendance of night shift staff has been about 5%. There is concern that with the small amount of interest shown from this group, the benchmark of 70% for live attendance may be jeopardized. Currently, the meeting schedule is communicated to all staff via email and posted announcements. Suzie thinks an incentive of a free meal for live attendance might improve attendance of the night shift crew.
How could a PICOT be developed with this information?
P = Population Describes the group upon which the intervention will have an effect.
Ex: night shift staff
I = Intervention – What we want to do that is different from what we currently do; the thing that is going
to impact the population identified
Ex. coupons for a free meal in the cafeteria
C = Comparison – Here the comparison is a before and after the intervention (incentive in this case)
Ex: communication of scheduled meetings via email and posted announcements
O = Outcome – What we want to see happen as a result of the intervention. The outcome should meet three criteria: direction (increase, decrease, etc), a baseline, and a goal.
Ex: increased mandatory meeting live attendance from 5% to 50%
T = Timing or Timeframe – When we expect to see the outcomes.
Ex: over the next 4 meetings
Now you can create the PICOT:
Among night shift staff(P), will offering a coupon for a free meal in the cafeteria(I), as opposed to only email invitations and posted announcements(C), increase mandatory meeting live attendance from 5% to 50% (O) over the next 4 meetings(T)?
REFERENCES USED MUST BE CURRENT, WITHIN 5 YEARS.
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