Project Management Concepts and Applications
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Project Management Concepts and Applications Introduction “Considerable research evidence has accumulated indicating that there is an increased likelihood for illness and injury among employees working in long-hour schedules and schedules involving unconventional shift work (e. g. , night and evening shifts)” (Dembe, 2009, p. 197). In addition, studies show that fatigue-related errors made by employees working these kinds of demanding schedules can have serious and adverse repercussions for public safety. “Nurses are working excessive amounts of hours without adequate rest.
This creates an unsafe environment for nurses and patients” (Meals ; Hartz, 2009, para. 2). Situation 1) Describe the situation-Staff schedule. Due to increased patient volumes, our nurses have been working fourteen to sixteen hours per day, four days a week. I have noticed that the staff is angry and burned out. We need proper staffing and scheduling. However, there are several barriers that make addressing this problem difficult. 2) Frame the right problem-The issue is that our department is staffing inappropriately. Our busiest days are Monday, Tuesday and Thursday averaging forty patients per day.
However, only four nurses are scheduled on our busiest days. That is ten critical patients per nurse, which is not only unsafe but leads to decreased morale, mistakes and an inability to leave work on time. 3) Describe end state and goals-My goal, over the course of this class is to change the staff schedule to match that of the operating room and to transition to Stay Staffed self scheduling systems hospital wide. The daily schedule will include but is not limited to a minimum of six nurses per day with schedules that parallel the operating room turnover times.
Also, I have begun working with upper level management on a program that allows critically ill, intubated patients to bypass the recovery room and be directly admitted to the critical care area that the patient is assigned to. This saves the patient and family money and decreases patient load for the recovery room staff. My goal is to hire three new nurses and change the staff schedule from (4) twelve-hour days to (3 to 4) eight to ten hour days and create a weekend on call team. Instead of mandatory overtime, create a sign up list and make overtime optional. Please see example of new schedule below:
RN – PACU| | Mon| Tues| Wed| Thur| Fri| RN A| | 8 to 6 | 8 to 6| 8 to 6| 9 to 7| | RN B| | 7 to 5| | 7 to 5| | 7 to 5 | RN C| | 12 to 10 | | 12 to 10 | 12 to 10| | RN D| | 1 to 11 | | 1 to 11 | 1 to 11 | | RN E| | | 8 to 6 | 8 to 6 | | 8 to 6 | RN F| | 10 to 8 | 10 to 8 | 10 to 8| | 12 to 10 | RN G| | 11 to 9 | 11 to 9 | | 11 to 9 | | RN H| | | 9 to 7 | | 10 to 8| 9 to 7 | RN I| | | | | 9 to 7| 10 to 8| RN J| | 8 to 6| 1 to 11| 9 to 7| 8 to 6| | New hires (train)| | | | | | |
RN K| | 9 to 7 | | | | | RN L| | | 12 to 10 | | | | RN M| | | | | | 11 to 9 | Project Vs. Routine Work According to (Grey ; Larson, 2008, p. 5) “a project is defined as a complex, nonroutine, one-time effort to create a product or service limited by time, budget and specifications. ” The aforementioned project and description fits within this definition and is indeed a project versus a day-to-day work assignment because this is not work that repeated over and over and upon completion of this project staff will have a standard system in place for scheduling.
Organizational Structure and Culture “Politics exist in every organization and can have a significant influence on which projects receive funding and high priority. Project selection may be based not so much on facts and sound reasoning, but rather on the persuasiveness and power of people advocating projects” (Grey ; Larson, 2008, p. 29). This is the structure and culture within my corporation. In order for projects to be taken seriously and funded, significant persuasion and research must be done and large numbers of staff must back the desired project.
The Chief Nursing Officer within the organization frequently says “persuade me and make me believe that this project will save time, money and aide in taking care of patients in a timely manner. Identify Alternatives A) Change the staff to (3 to 4) eight to ten hour days with varying shifts and create a weekend on call team. B) Keep the nurses on twelve hour days but hire an after hours team to relieve the day shift. C) Send outpatients to a different department in order to be discharged home. Risks to the Project Staff resistance. People have lives and families.
Changing an employees schedule can greatly affect their lives. Also, people can be very resistant to change. Management might not approve changes. Training employees in another department according to ASPAN standards is difficult and time consuming. Factors Affecting the Project 1) Staff indecisiveness regarding schedules and frequent requests to switch days and entire shifts. The staff often submit requests for vacation days after or in the midst’s of the schedule’s creation. Lastly, several staff members refuse to submit their desired schedule, leaving the scheduler with the responsibility of assuming set shifts. ) Various doctors refuse to bypass the Recovery Room and take their patients directly to the Intensive Care Unit thus increasing patient costs and putting a greater strain on an already limited staff. 3) Upper managements refusal to identify the need for additional staff, refusal to put policies in place and enforce them for vacations and scheduling. Upper managements reluctance to try electronic self scheduling, which always management to block out and open times and assign staff ranges to schedule themselves.
Upper managements limited involvement and staff encouragement regarding new schedules and the possibility of increased flexibility. 4) Creating the schedule is very time consuming. It takes a week and a half to two weeks to create the staff schedule, which limits nurse to patient interaction and ability to give proper care. Conclusion Staff safety and flexible schedules are a desired feature for management within my organization. However, staff feedback and management involvement in the process of streamlining the scheduling process are critical.
This project will be heavily evaluated during the course of six weeks with the goal of finding a permanent solution that is timely, while meeting staff and management needs. References Dembe, Allard. Ethical Issues Relating to the Health Effects of Long Working Hours. Journal of Business Ethics, Jan2009 Supplement 2, Vol. 84, p195-208, 14p; Gray, C. F. ; Larson, E. W. (2008). Project management: The managerial process (4th ed). New York, NY: Mc-Graw-Hill/Irwin. Meals, J. , Hartz L; Limiting mandatory overtime for RNs in the 26th session.