PM FPX 4010 Assessment 2 Interview and Interdisciplinary Issue Identification

PM FPX 4010 Assessment 2 Interview and Interdisciplinary Issue Identification

Interview Summary

Interviewing experienced healthcare professionals can help identify organizational challenges, evaluate existing strategies, and develop practical solutions that improve patient safety and quality of care. For this interview, I selected my assistant nurse manager because she has worked in the organization for five years and has experienced departmental changes from multiple perspectives. Her experience provided valuable insight into the challenges associated with staffing, leadership, and interdisciplinary collaboration.

The hospital where we work was recently acquired by a larger healthcare organization, resulting in several organizational changes that are still being implemented. The new director appears committed to supporting employees and empowering staff members across different departments, including nursing, pharmacy, environmental services, food services, and medical services. This approach recognizes that every healthcare professional contributes to the organization’s overall performance.

My assistant nurse manager is responsible for several administrative and clinical functions, including charge nurse responsibilities, staff scheduling, paid time off (PTO) management, payroll, and PRISM reviews. During the interview, we discussed staffing shortages at both the unit and organizational levels. We also examined how these challenges affect daily nursing responsibilities, patient safety, and the quality of care. The discussion focused on identifying potential solutions and determining whether current improvement efforts are producing meaningful results.

Issue Identification: Nurse Staffing Shortages and Patient Safety

One of the most significant concerns identified during the interview was inadequate nurse staffing. Staffing shortages increase the workload for available nurses, create operational challenges for nurse managers, and may compromise the quality and safety of patient care. Although the assistant nurse manager has administrative responsibilities, she frequently assumes charge nurse duties when the designated charge nurse must manage a full patient assignment. This situation reduces the time available for leadership, staff support, coordination, and other essential responsibilities.

Understaffing can also increase individual nurses’ patient assignments, making it more difficult to provide timely assessments, administer medications safely, monitor changes in patient conditions, and complete documentation. Hairr et al. (2014) examined the relationship between nurse staffing, job satisfaction, and retention, highlighting the importance of adequate staffing in supporting nursing workforce stability. Staffing concerns should therefore be addressed as both a patient safety issue and an organizational workforce challenge.

High patient turnover further complicates staffing shortages. Nurses must frequently manage admissions, discharges, patient education, medication reconciliation, documentation, and communication with other healthcare professionals. For example, a nurse discharging several patients during a single shift must ensure that each patient understands medication instructions, follow-up appointments, warning signs, and other essential information. These responsibilities require considerable time and attention, particularly when the nurse is simultaneously responsible for other patients.

PM FPX 4010 Assessment 2 Interview and Interdisciplinary Issue Identification

After completing discharges, nurses may need to admit new patients, review medical histories, reconcile medications, conduct assessments, and coordinate treatment plans. When these activities occur alongside high patient assignments and limited staffing, nurses may experience increased cognitive demands and reduced opportunities to complete tasks without interruption. These conditions can contribute to delayed care, incomplete communication, medication-related errors, and inadequate discharge education.

Another concern identified during the interview involved physicians entering their own orders into the electronic health record. When physicians rely heavily on nurses to facilitate order entry, nursing workload can increase, particularly when multiple physicians conduct rounds simultaneously. Nurses may be required to coordinate orders, respond to patient needs, administer medications, and complete other clinical tasks at the same time.

Improving communication and clarifying responsibilities between nurses and physicians could reduce unnecessary workload and strengthen patient safety. Clausen et al. (2017) emphasized the importance of developing competencies for interprofessional collaboration among nurse and physician managers. Because both groups participate in clinical decisions and organizational leadership, coordinated decision-making can support more effective healthcare delivery.

Change Theories That Could Support an Interdisciplinary Solution

Lewin’s three-step change model and the Plan-Do-Study-Act (PDSA) cycle provide practical frameworks for addressing staffing shortages and improving interdisciplinary workflows. Both approaches emphasize identifying problems, implementing appropriate interventions, and evaluating whether changes produce the intended outcomes.

Lewin’s Three-Step Change Model

Lewin’s change model consists of three stages: unfreezing, changing, and refreezing. The model can help healthcare organizations introduce new staffing practices, improve communication, and establish sustainable improvements in patient care (Wojciechowski et al., 2016).

The unfreezing stage involves recognizing the need for change and helping stakeholders understand why existing practices may be ineffective. In this situation, hospital leaders could review staffing reports, patient assignment data, overtime records, incident reports, and employee feedback to demonstrate how inadequate staffing affects workflow and patient safety. Nurses, physicians, nurse managers, and human resources representatives should participate in identifying the underlying causes of the problem.

The changing stage involves implementing strategies to address the identified concerns. Potential interventions include recruiting additional registered nurses and patient care technicians, evaluating nurse-to-patient assignments, establishing an admission and discharge nurse role, and clarifying responsibilities for entering medical orders. Interdisciplinary education and regular communication can help employees understand their responsibilities and adapt to the revised processes.

The refreezing stage focuses on integrating successful changes into routine operations. Hospital leaders can support sustainability by updating policies, incorporating new responsibilities into job descriptions, monitoring staffing outcomes, and providing ongoing education. Regular reviews of patient safety indicators, staff feedback, and workflow efficiency can help determine whether the changes should be maintained or adjusted.

Plan-Do-Study-Act (PDSA) Cycle

The PDSA cycle is another useful framework for testing quality improvement interventions on a small scale before expanding them across an organization. The Institute for Healthcare Improvement (IHI, n.d.) describes improvement methods that support systematic testing, evaluation, and refinement of changes.

During the planning stage, an interdisciplinary team would identify a specific staffing or workflow problem, establish a measurable objective, and select an intervention. For example, the team could develop a pilot program in which a designated nurse supports admissions and discharges on a medical-surgical unit.

During the implementation stage, the team would introduce the intervention for a defined period and document its effects. The study stage would involve reviewing relevant information, such as discharge completion times, patient education documentation, readmission rates, staff workload, and patient satisfaction. Finally, during the act stage, the team would determine whether the intervention should be adopted, modified, or tested again.

The PDSA approach allows healthcare organizations to evaluate proposed changes before committing substantial resources. It also encourages continuous learning and provides an opportunity for nurses, physicians, managers, and other stakeholders to contribute to improvement decisions.

Leadership Strategies for an Interdisciplinary Solution

Effective leadership is essential for addressing nurse staffing shortages because the issue involves workforce planning, resource allocation, communication, and patient safety. Nurse managers and organizational leaders should use collaborative, evidence-based strategies that involve employees in identifying problems and developing realistic solutions.

One practical strategy is to establish an interdisciplinary quality improvement team consisting of nurse managers, bedside nurses, physicians, human resources representatives, patient care technicians, and quality improvement specialists. This team could review staffing patterns, patient acuity, admissions and discharges, overtime requirements, and patient safety indicators. Examining these factors together would help leaders distinguish between temporary staffing challenges and persistent organizational problems.

The team could then use the PDSA cycle to test a designated admission and discharge nurse role. Shimp and Neville (2017) examined the economic implications of introducing a discharge nurse role on a medical-surgical unit. Their work provides a relevant example of evaluating a specialized nursing role and its potential operational and financial implications.

PM FPX 4010 Assessment 2 Interview and Interdisciplinary Issue Identification

A pilot program could be evaluated over approximately three months, with the exact duration determined by the unit’s needs and available resources. During this period, leaders could compare discharge efficiency, completeness of patient education, staff workload, overtime, patient experience, and relevant readmission measures before and after implementation. The results should be presented to hospital leadership and other stakeholders to support decisions about whether the program should continue or expand.

Leadership should also prioritize transparent communication and employee engagement. Staff members who experience workflow problems firsthand can identify practical barriers that may not be apparent in administrative reports. Regular interdisciplinary meetings, anonymous feedback opportunities, and structured reviews of quality improvement data can help employees contribute without fear of blame.

In addition, leaders should evaluate recruitment and retention strategies. Hiring additional registered nurses and patient care technicians may help reduce workload, but recruitment alone may not resolve the underlying problem if turnover remains high. Competitive compensation, supportive management, professional development, effective scheduling, and a healthy work environment can contribute to workforce stability. A comprehensive approach should address both immediate staffing needs and the organizational factors that make it difficult to retain qualified employees.

Collaboration Approaches for Interdisciplinary Teams

Interdisciplinary collaboration can improve patient safety by coordinating responsibilities, strengthening communication, and ensuring that healthcare professionals work toward shared goals. During the interview, my assistant nurse manager discussed the Team Members as Customers (TMAC) surveys completed earlier in the year. Feedback from these surveys highlighted the need for adequate staffing and better support for employees responsible for direct patient care.

The first collaborative priority should be evaluating the unit’s staffing requirements. Hospital administrators, nurse managers, and human resources personnel should review recruitment needs, turnover, patient acuity, scheduling patterns, and available financial resources. Staffing decisions should reflect patient needs and applicable organizational policies rather than relying exclusively on fixed staffing numbers.

A second strategy is to consider introducing an admission and discharge nurse. This role could help coordinate patient transitions, reinforce discharge instructions, review medication information, and communicate follow-up requirements. By assigning these responsibilities to a designated professional, the organization may reduce some of the workload experienced by bedside nurses. However, the role’s effectiveness should be evaluated using measurable outcomes rather than assumed in advance.

PM FPX 4010 Assessment 2 Interview and Interdisciplinary Issue Identification

A third strategy is to clarify responsibilities for entering and verifying medical orders. Physicians and other authorized prescribers should enter orders directly into the electronic health record when feasible and consistent with organizational policy. Standardized workflows, clear communication protocols, and appropriate order verification procedures can reduce unnecessary interruptions and help prevent misunderstandings. Nurses should continue to review orders within their professional responsibilities and promptly clarify incomplete, conflicting, or potentially unsafe instructions.

The interdisciplinary team should also establish shared performance measures. These may include medication error reports, missed or delayed nursing care, discharge education completion, patient satisfaction, staff overtime, turnover, and readmission rates. Reviewing these measures regularly can help the team identify whether changes improve care or create unintended consequences.

Ultimately, successful collaboration requires mutual respect, clear accountability, and shared responsibility for patient outcomes. Nurses, physicians, administrators, and support staff contribute different forms of expertise. When these perspectives are integrated into decision-making, healthcare organizations are better positioned to implement practical and sustainable improvements.

Conclusion

The interview with my assistant nurse manager identified inadequate nurse staffing as a significant organizational concern affecting workload, interdisciplinary communication, and patient safety. High patient assignments, frequent admissions and discharges, competing responsibilities, and unclear workflow expectations can make it difficult for nurses to provide timely and consistent care.

Lewin’s three-step change model and the PDSA cycle offer structured approaches to addressing these challenges. Through interdisciplinary planning, pilot testing, measurable outcomes, and ongoing evaluation, hospital leaders can determine which interventions are most effective for their organization. Potential strategies include recruiting additional nursing staff, implementing a designated admission and discharge nurse role, improving electronic order-entry workflows, and strengthening communication among healthcare professionals.

Sustainable improvement requires more than introducing new procedures. Leaders must also engage employees, address workforce retention, allocate resources appropriately, and evaluate the effects of interventions on both patients and staff. By combining evidence-based change management with collaborative leadership, healthcare organizations can work toward safer patient care, more efficient clinical workflows, and a more supportive work environment.

Frequently Asked Questions (FAQs)

What is the main issue identified in PM FPX 4010 Assessment 2?

The primary issue is inadequate nurse staffing and its effects on workload, patient safety, care coordination, and the quality of nursing services. High patient assignments and frequent admissions and discharges can make it difficult for nurses to complete essential clinical responsibilities efficiently.

How can Lewin’s change theory help address nurse staffing shortages?

Lewin’s model guides organizations through recognizing the need for change, implementing new strategies, and incorporating successful practices into routine operations. Healthcare leaders can use the model to introduce staffing improvements, clarify responsibilities, and establish ongoing evaluation procedures.

How can the PDSA cycle improve interdisciplinary collaboration?

The PDSA cycle allows healthcare teams to plan, test, evaluate, and refine interventions on a small scale. It can help determine whether changes such as a dedicated discharge nurse or revised electronic order-entry workflow improve patient care and operational efficiency.

Why is interdisciplinary collaboration important in nursing?

Interdisciplinary collaboration brings together the knowledge and skills of nurses, physicians, administrators, and other healthcare professionals. Coordinated decision-making can improve communication, reduce workflow problems, support patient safety, and promote more consistent care transitions.

What strategies can hospitals use to improve nurse staffing and patient safety?

Hospitals can evaluate staffing requirements, recruit and retain qualified employees, improve scheduling, establish specialized admission and discharge support, standardize communication protocols, and monitor patient safety indicators. These strategies should be tailored to patient acuity, organizational resources, and measured outcomes.

References

Clausen, C., Cummins, K., & Dionne, K. (2017). Educational interventions to enhance competencies for interprofessional collaboration among nurse and physician managers: An integrative review. Journal of Interprofessional Care, 31(6), 685–695. https://doi.org/10.1080/13561820.2017.1347153

Hairr, D. C., Salisbury, H., Johannsson, M., & Redfern-Vance, N. (2014). Nurse staffing and the relationship to job satisfaction and retention. Nursing Economics, 32(3), 142–147. https://pubmed.ncbi.nlm.nih.gov/?term=Nurse+staffing+and+the+relationship+to+job+satisfaction+and+retention

Institute for Healthcare Improvement. (n.d.). How to improve. https://www.ihi.org/resources/Pages/HowtoImprove/default.aspx

Shimp, K., & Neville, B. (2017). Economic implications of creating a discharge nurse role on a medical-surgical nursing unit. Med-Surg Matters, 26(3), 4–6. https://search.ebscohost.com/

Wojciechowski, E., Pearsall, T., Murphy, P., & French, E. (2016). A case review: Integrating Lewin’s theory with Lean’s system approach for change. Online Journal of Issues in Nursing, 21(2), Manuscript 4. https://doi.org/10.3912/OJIN.Vol21No02Man04