Coordination is a means of dealing with interdependencies by effectively linking together the various parts of an organization or by linking together two or more organizations pursuing a common goal (Shortell & Kaluzny, 2005). Coordination is also one of the most important parts of management as well. During the interview I had with the director of nurses at a nursing home, we talked a lot about how the place was run and how it stays coordinated. It takes a lot of work being the director of nurses and you have to make sure everyone is doing their part to make it work.
Each nurse has 5 patients they have to take care of daily, now making sure these nurses are taking care of their patients and giving the patients what they need are the managers of each wing. There is an east wing and a west wing. Each wing has a day manager and a night manager and 4 nurses. Each nurse has to make sure their patient gets their medication, showers, physical therapy and if they cannot walk their selves, they have to make sure they get to the kitchen, or their food is brought to them, they also have to make sure they get to their physical therapy appointments.
In the kitchen, they have a set of nurses who keep an eye on the patients and make sure they get special meals, if they are on a special diet, and feed the patients if needed. In the game department, they have nurses who take the time to play games with the patients and set up bingo nights, etc. They also have a physical therapy department that has a set of 3 nurses who conduct physical therapy for the patients who need it. They also have physical therapy manger who makes sure all goes right and makes the scheduling for the patients.
The director of nurses has to make sure all of this is going on and everyone is doing their part. If there is a problem, the nurses have to go to their department manager and then if they cannot solve it, the manager goes to the director of nursing. The director of nursing interviews lay offs, switches people in departments if needed and makes sure everything and everyone is up to code. The coordination of internal and external services is the coordination of things within a company or organization and the things that are outside a company or organization.
While talking with the director of nursing, she was telling me not only does she have to watch after the nurses in the company, but there is a company from the outside that does the same. They tell her when she needs to cut hours, or when she needs to bring on more people for a shift or two. The external company comes in sometimes unannounced to make sure things are going smoothly and everything is up to code. The external company also watches over the director of nursing to make sure she is doing her job correctly and running the place how it needs to be run.
Another external service would be the doctors that come in to check the patients that need to be checked periodically. Sometimes they cannot provide the transportation needed to take patients to and from the doctor’s office, so doctors come a few times a week to check on the patients and make sure all is well and that the nurses are giving them the correct medication and the proper care that is needed. The key players in the nursing home are all the staff members. Each member plays their own part in coordinating the way the nursing home is ran.
Mainly the director of nursing and the nursing management play a big role in it. If it wasn’t for the managers of each department controlling what was going on and keeping what was going on and for the director of nursing overseeing everything and making sure everything is in order, things could be chaos and the patients wouldn’t be getting the care that they needed. Coordination plays an important role in performance of healthcare organizations. Recent studies of other health care delivery settings also indicate that effective coordination of staff leads to better clinical outcomes (Shortell & Kaluzny, 2005).
Coordination takes place by the communication the staff members have with one another and how well they work together. If they all communicate well together and work together like a time, everything will fall in to place and be very coordinated. If they don’t talk as they do things, and do not work together, things won’t go well and they will not reach the goal of becoming a successful organization or reaching the goal of taking care of the patients. In the nursing home, their one and only care are the patients, they all work together and make sure things are done as a team and everything runs smoothly.
To ensure coordination in the nursing home, they have a list, kind of like a ‘to do’ list. Each department has a list of things they need to do as a department and then they have a list each nurse needs to do with their patient. They have time limits that certain things need to be done by, and everything needs to be done by the end of their shift. The department managers make sure things are getting done, and each nurse is to check in with them when they are done with their department tasks.
The director of nursing pops in to make sure the patients lists are getting done properly and the department itself if organized with what they are doing. They like to make the place look clean and presentable incase external services come in or even OSHA. They have tasks like cleaning floors and windows and bathrooms, patient rooms, etc. Each person is assigned a few tasks and has to make sure it is done. It keeps everything and everyone organized. They keep coordination pretty well maintained.
My great aunt was in that nursing home for a little over a year and they always knew where the patients were, whether it was in the game room, the kitchen, the butterfly garden, or physical therapy. The patients nurse and the wing manager always knew where she was and always had a list of when they left and what time they came back, etc. Ways for coordination to be identified would be if something major was to happen and they didn’t have a plan, they can make one and if something like that were to happen again, they would know what to do.
We had three hurricanes back to back here one year, and the first one they weren’t too sure what to do, they had meetings etc, by the time the third one came, they had a plan and knew what to do. Each person was assigned and area and had to stay there until they were told otherwise. They had designated spots for each wing of patients and knew where everyone was at each moment in time. If a conflict were to occur, the staff member would have to go to their department manger first, and if that didn’t work they have to go to the director of nursing.
I believe that is a good way to try and resolve conflict, to go to your assigned manger first and then the manager goes to the manager goes to the overall manager or if you aren’t getting the help you need, you go to them. Having meetings is also another good way to resolve conflict. It is never a good thing to have conflict in the workplace, it shows sometimes and when you are dealing with patients, it can get stressful. Going to the head person, or having a staff meeting are always good ways to go. My thoughts on coordination, decision making, productivity, and efficiency of this organization is very simple.
All of these are what is needed to be a successful, well organized organization. Being coordinated and knowing what you are doing at all times will help reduce the risk of conflict or getting things mixed up, such as records etc. The ‘to do’ list they have for each department is a good way to keep track of what is being done and making sure that it is done and it avoids any confusion like if someone did it or not. The decision making and productivity doesn’t just go through the internal services, it also involves the external services.
The external services basically have the last say on big decisions. I think that is a fairly good idea because each healthcare office has to follow rules and regulations from external services and if that means it can cost them jobs, or their practice, etc, leave what needs to be left to external services. This particular organization is very efficient it seems. Everyone knows what they have to do and when and takes care of what needs to be taken care of when it comes about. This organization has been around for quite sometimes and has never seemed to have a major problem.
When my aunt was in there, she would call the nurses station and someone was there in a matter of seconds asking her what she needed. Very efficient staff makes people feel safe being there. You never know when you may have to be put in a nursing home or hospital. Having a place that is very well coordinated and organized like this place, is a place we all want and a place that there should be more of. Management Interview Paper References Shortell, S. M. , & Kaluzny, A. D. (2005). Coordination and Communication. In Healthcare Management (p. 240). : . Shortell, S. M. , & Kaluzny, A. D. (2005). Healthcare Management (5th ed. ). : .
