This assignment is worth 50% of your final grade. Presentation and hard copy submission of this assignment is due on December 8th, 2018.

So, the name of this course is Organizational Theory and Management. We are to incorporate a component of Organizational Behaviour into an individual research project in our department at our workplace. The component of Organizational Behaviour I chose to focus on is Workplace Communication.

SECTION 1 – PROBLEM STATEMENT 

Describe a problem that is related to the course content and is being experienced in an organization of your choice. Answer the questions: Who are the stakeholders and how are they affected? How do you feel about the issue/problem? What outcomes and strategic goals will the project support or affect? 

Feel free to reconstruct and rephrase this problem statement to include what the above is describing and requiring. I think a bit more needs to be added to it.

Problem Statement: Ineffective workplace communication among the surgical staff (i.e. surgeons, operating theatre nurses, attendants etc) leads to delays in operating theatre start time and cancellation of surgeries. 

SECTION 2 – OBJECTIVES AND GOALS 

Clearly state a minimum of objectives that are concise, verifiable, feasible, and measurable. State the expected outcomes or benefits (what is the impact on the unit business processes, systems, people, the organization etc?).

I suppose you can state a minimum of three objectives.

SECTION 3 – NEEDS ASSESSMENT AND RESEARCH METHODS 

In this section, you should conduct an assessment of the organization, in order to provide a diagnosis and to validate the problem as identified under the Problem Statement section. You are free to conduct site visits/observations,and state your findings of the current situation. Show evidence of how the client system is responding to the problem. Identify disparities in perceptions, strengths, weaknesses, problem solving abilities, support systems List the human and other resources needed to complete your project successfully. You are to assume the role of a consultant and to refrain from revealing the identity of the organisation while sharing ample details of the departmental or service setting. 

Feel free to include a sample questionnaire here as a means of research methods asking about the ineffective workplace communication. It can be included in the index. Maybe you can say the questionnaire was administered to approximately 50 people in the department.

Interviews with the head nurse(s) of the operating theatre and the consultant surgeons should be done.

State what you observe as well.

There is also a surgical logbook whereby every operation that is done is logged together with the patient’s name and hospital registration number. A retrospective approach or prospective approach can be used whereby, for example, you can collect data relating to the time patient was sent for, from the surgical ward to the operating theatre. Normally there is huge delay where this is concerned because many times, the staff is unsure of which surgical patient to send for first to operate on. Not because their names are first on this list means that they will always be first to operate on.

Below is just a brief outline how the surgical department is run.

I belong to the surgical department (specifically orthopaedic surgery). In my organization (public hospital), there are 2 orthopaedic surgery theatre days (Tuesday and Thursday). On those two days only orthopaedic surgeries (both urgent and elective) are performed in the operating theatres unless there is an emergency surgery is to be done by the other surgical specialities (eg. General surgery, obstetrics and gynaecology, ophthalmology etc). The emergency surgeries would take precedence over any urgent or elective orthopaedic surgery as these are life threatening. Hence, they are called emergencies.

The day before orthopaedic surgery operating days (that is the Mondays and Wednesdays), Operating Lists are created with the names of the patients due for surgery the following day. Apart from the names of the patients, the list also has their diagnosis and surgery that is going to be performed by the surgeon. Patients are to be admitted on the surgical wards on the day before the surgery, if they are not already an inpatient. They are then prepped pre-operatively (bloods, xrays, ecg, consent etc). Once these investigations are good they will fast (from both food and water) from midnight until they are called for surgery the next day. They are only allowed to eat after the surgery has been done and they have returned to the wards from the operating theatre.

On the morning of surgery, the head nurse or nurse in charge in the operating theatre, has to call for the first three patients, since there are three operating theatres. This part is entirely dependent on the surgeon. Sometimes the list is done in a particular order but the patients that are listed first in each of the three theatres are not the ones being called for first. Some reasons this happen are:

1) The junior surgeons are unsure of what cases can be done since there is lack of communication with the senior surgeons. The senior surgeons may each have a different order in which they would want to start. Hence communication is always the issue.

2) The patient may not be fully pre-operatively prepped and so prepping of the patient has to be completed by the surgical ward nurses and a check list done before they can come to theatre.

3) The nurses on the surgical wards are handing over to the other shift of nurses and so would tell the operating theatre nurses they are busy at that point in time, to call back within the next 15 minutes.

4) Sometimes an orthopaedic surgery may require an implant from the companies and the representatives from the companies bringing the implants may be late

5) Sometimes a particular instrument set for an operation has not been sterilized and has to go to be sterilized and so another case would have to be sent for. It is only found out that it is not sterilized on the day of the surgery.

Most times once delays happen and operating theatre start time is lengthened, the ultimate outcome is cancellation of cases (especially elective, non- urgent cases).

SECTION 4 – ANALYSIS 

This section should represent an analysis of your findings under the Section: Needs Assessment and Research Methods (Section 3 above) and should address the problem in the context of theories and concepts covered during the course. Assumptions may be made to fill knowledge gaps; they may later prove to be incorrect but may have a significant impact on the project. List only those assumptions that have a reasonable chance of occurring. List any known constraints imposed by the environment or by management.

This will obviously also have graphs/charts etc. Make up figures that conclude, there is ineffective workplace communication, that leads to the delay in theatre start time and cancellation of cases. It is to relate back to section 2 I suppose.

SECTION 5 – DESIGN TREATMENT, SOLUTION OR ACTION PLAN 

Your proposed solution to the problem and which follows from Sections 1, 2, 3 and 4. In this section, you should outline and discuss the specific strategic initiatives to be employed to problem solve the case e.g. develop an intervention / develop a training plan.

Below I have just briefly described a solution. This is just an example of something along the lines but way more is needed here. You are better at this ????. More solutions/action plans etc, the better it is.

Being a medical professional and a member of the surgical department, in my opinion it is absolutely necessary for effective workplace communication to exist. Strategies and recommendations to overcome barriers must therefore be put into place or done to ensure that the communication process is improved. Most importantly, surgical briefings between all categories of surgical staff can be done two to three times weekly to facilitate clear and effective communication, as it creates an environment for all members of the surgical team to openly address a perceived problem(s) with surgical patients. Every member of the team should actively participate to ensure the team in on the same page. It permits open communication to discuss what went well or could have been done better to avoid the delays that happened. It can facilitate discussions of how to solve problems including communication issues so that there is no delay in operating theatre start time and hence cancellation of surgeries. These briefings and debriefings can be effective through the use of a surgical checklist. Surgical checklists can therefore be employed to integrate the process items into one tool to ensure that team members communicate the necessary information with each other and perform essential safety steps for every surgical patient. Overall, these strategies would enhance communication among surgical team members, other surgical healthcare staff and the surgical patients to provide effective surgical health care for patients.

SECTION 6 – BIBLIOGRAPHY 

Your project must include a bibliography 

SECTION 7 – APPENDICES 

These must be referenced in the body of the project and appropriately labelled.

Of course if you want to look at ineffective workplace communication in the surgical department from a different angle, feel free to change up everything according to suit. I believe you are an excellent writer and would not disappoint me. Remember everything relates back to Ineffective workplace communication in the surgical department.

The professor also stated she would like a literature review to be done with at least 6 references.

The entire paper and references used are to be done APA style.

CRITERIA TO FOLLOW 

Please use the following criteria to guide your individual project:

  

Topic Heading

Mark

 

Table of Contents

0.   5

 

Executive Summary

5

 

Introduction & Background

5

 

Problem Statement

15

 

Literature Review

7

 

Methodology

6

 

Data Collection

10

 

Presentation of Findings

10

 

Analysis of Findings

30

 

Conclusion

5

 

Bibliography

2

 

Appendices

0 .5

 

Presentation and Use of Language

4

 

TOTAL

100

Marks will be converted to the 50% for Individual Project

Word Count is 3000 excluding table of contents, bibliography and Appendices. 

The presentation and use of language seen in the criteria above is not part of this written paper. This order only involves the written individual research paper.

Below are reasons that lead to cancellation of cases in general. This may or not may be related to ineffective workplace communication. Just for your knowledge base.

1.1 A review of the staff rosters in the operating theatre were compared to the number of surgeries done per day using the staff per full – time equivalent (FTE) method, which indicates staffing is adequately rostered. 

· It was revealed that for each operating theatre, there were two (2) assigned nurses, one scrub nurse and one circulating nurse. Absence of either one of these would result in a replacement nurse to fill the position in order for the respective duties to be fulfilled on most occasions. Very rarely would an operating theatre would become non – functional due to lack of theatre staff between the hours of 8am to 4pm.

1.2 There are two (2) operating theatre days, that is, Tuesday and Thursday, assigned to Orthopaedic Surgery per week. There are three (3) operating theatres in total. 

· On a Tuesday only one (1) operating theatre is assigned for orthopaedic cases, whereas, on a Thursday, all three (3) theatres are assigned for orthopaedic cases. 

· The times allocated for these cases are 8am to 4pm. After 4pm, there is closure of two operating theatres unless there is a case being completed after which it closes. 

· Only one (1) operating theatre would function in emergency mode after 4pm, that is, strictly for on – call emergency cases from any of the surgical departments (Orthopaedic Surgery, General Surgery, Ophthalmology and Obstetrics and Gynaecology).

3.71 There was a delay in the starting time for these surgeries by approximately an 

 hour as the ward nurses are either handing over at this point in time or the 

patient is not fully prepped to come to the operating theatre and this results in 

the operating theatre attendant having to wait until either activity is done.

3.72 The time taken to give the patient anaesthesia, whether, general, regional or  

spinal, would take approximately half hour (30 minutes) to forty five (45 

minutes) on average or sometimes longer depending on the difficulties 

encountered by the anaesthesiologist. The same applies with recovery of the 

patients.

3.73 On some occasions, difficulties would be encountered by the orthopaedic 

surgeons and cases may not be as straight forward as expected and so, the 

average time taken for a particular surgery would be longer than estimated.

3.74 Between cases the operating theatres needed to be cleaned so as to make the 

environment as sterile as possible for the next case. Nursing staff and assistants 

would sometimes not be available as needed to perform these duties in a timely 

manner.

3.75 For some cases that required special instruments and sets, sterility of the 

instruments may not have been done in a timely fashion so as to be ready for use 

in the next case as it was used in a previous surgery. Also, instrument sets that 

are brought in by the different companies for use in the surgery would have 

sometimes been used the previous day for a similar surgery in a different 

hospital and in cases like these, instruments would need to be re – sterilized and 

hence a longer waiting period between surgeries.

3.76 It was observed that the new theatre staff for example, scrub nurses, are not very 

familiar with the instruments required for the orthopaedic surgical cases and so

some cases would take a longer time than expected.

3.77 That one anaesthetic machine is non – functional, thereby, restricting the amount 

of general anaesthesia and spinal anaesthesia cases to be done in this theatre and 

therefore, in total. 

· Because of this non – functional anaesthetic machine, the 

operating theatre lists were restricted to urgent cases only, unless there were 

none, in which case, elective surgeries would be scheduled.

· Because there are only two (2) functional anaesthetic machines, two (2) major cases are unable to be done at the same point in time, and only a major case and a minor case can be done simultaneously in the two (2) theatres. This is done in order to accommodate any emergency cases that may present for surgery during the time period of 8am to 4pm.

All of these incidents and events, in essence contribute to limited theatre time and cancellation of elective surgeries such as joint replacement surgeries.

1.3 There are two (2) surgical wards, that is, male and female, in the hospital. The male

surgical ward houses both Orthopaedic Surgery and General Surgery patients and the female surgical ward houses Orthopaedic Surgery, General Surgery and Gynaecology patients. 

· By liaising with the Head Nurse of each ward and examining the admissions book to determine the number of available bed spaces and potential bed spaces from possible discharges, it was revealed that, on the majority of pre – operating theatre days, the majority of patients scheduled would have to wait for a potential discharge from the ward and the urgent cases would be given priority over bed spaces than the elective cases like joint replacement surgeries. 

· It was also revealed that bed spaces from potential discharges on the ward would be given priority to critical patients who were admitted and is still in the Accident and Emergency Department because there were no bed spaces at the time of their admission. This in turn, resulted in patients who are scheduled for joint replacement surgeries, not having access to a bed and hence cancellation of their surgeries on many occasions.