Types of Delivery Systems

Understanding Healthcare Systems is not always an easy task and we as nurses find many obstacles and challenges along the way. But as leaders and advanced nurses we must approach these challenges and problems solve them so that all parties are on the same page.

Types of Delivery Systems - Resources
Being in an acute care setting and working in a hospital inside a hospital, we see situations like this a lot. We had a patient that had a closed head injury and was under our care as well as having several services from our host hospital. His cardiologist came into see him one day and felt he was having some irregular heart rate episodes and insisted we transfer him to the CCU to be monitored. Our physicians was insisting on him staying right where he was and just being monitored. The whole situation was blown out of proportion and as usual the nurses were caught in the middle and needed to encounter a lot of yelling and demands. One of the problems was our patients could not leave our hospital and transfers to another unit without being discharged from our hospital and admitted to our host. The patient would then need to be readmitted to our hospital once released by his cardiologist. The cardiologist did not understand the matter of our patients verses the host's patients. Just because we were in the same building didn't mean we shared the same patients. We were capable of wiring the patient and monitoring him for the cardiologist. After several days of the two physicians fighting over what to do with the patient, we finally was able to get the cardiologist to understand our position and agree to keep the patient where he was and just monitor him.

The Alternative Approach

An alternative approach for our facility would have been to have more doctors on our staff including a cardiologist. Unfortunately our facility was very new and our staff was very small and not many of the physicians in the area were too supportive to our integration. However, we could have had more information available about us and make sure that the physicians in the area that would be seeing our patients fully understood the process and how it worked. (Jossey-Bass-2003). That is just one of the problems we faced as a hospital within a hospital, but we are learning and educating everyday and will continue to provide the best care with the help of our host.

The rationale for the problem we encountered would be to make sure all your staff are aware of what doctors are coming in and making sure that it is explained to them that these patients are not part of our host and any transfers would mean discharge and readmit. Having medical staff meetings and educating the physicians on the whole process. It is important that when a new health care system comes into an area, we educate the entire public. Making sure all key components are discussed and understood.

Challenges the RN Faces

One of the challenges that we will face in the process of informing all important parties, is a communication barrier. A lot of our physicians are very difficult to talk to and to understand. Most of them have very broken English and have a difficult time understand English. It seems as if you tell them something and they hear something else. You have to repeat yourself and they have to repeat themselves and everyone gets very frustrated. The communication barriers are the most difficult to overcome unless you are fortunate enough to have multilingual speaking staff. (Judith Leavitt-2002). This communication problem is very frustrating for everyone and it also makes the doctors more insisting on getting their way. Rather than a major confrontation, they just demand you do what they say. Approaching our physicians calmly and speaking slowly so that they can understand you and trying to take time to listen closely to them as they communicate will make things easier. It is a process that is going to take time and patience from all parties. It is something that we all need to consider when we are put into new situations and we don't always understand the process.

References

Jossey-Bass, Health & Health Care 2010. (February 2003). The Forecast, The Challenge, 2nd Edition.

Judith Leavitt, Diana Mason (2002). Policy & Politics in Nursing and Health Care.