Mobilization plan for the international medical mission.

Understanding the impact of mobilization on staffing patterns and nursing at a health care organization.

Determining organizational structure and distribution of power in the mission team using case studies.

Examining potential multicultural and power issues the team may encounter during the medical mission to Africa.

Mobilization of international missions are complex undertakings that require (a) meticulous planning of resources: human, fiscal, and material resources; (b) careful structuring of team member roles and authority; and (c) empowering the team to complete missions goals. The social structures, health care regulations and infrastructure, and needs of the host country also factor in the mobilization plan (Hawkins, 2013). Team members have to be prepared for the individual, professional, and organizational factors of moving temporarily to a new country.

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The scenario:

A medical center has committed 20 nursing professionals (NPs) to a four-month-long multinational health mission in Liberia, West Africa, to treat patients affected by a highly contagious virus in a ‘hot zone.’ The team will also include administrative staff and physicians who will work with the NPs to achieve common goals. NPs are the primary care givers in any health setting. They are the ones assisting physicians, administering treatment and monitoring patient status in the clinical setting. Therefore, the majority of the staff on the medical mission will be NPs.

This presentation will detail plans for the mobilization of interprofessional health care workers to Africa. It will focus on the following points:

Identifying major stakeholders in the health care organization who will be affected by the mobilization plan.

Determining the impact of mobilization on staffing patterns and nursing at the organization.

Describing the organizational structure of the international medical mission and how power will be distributed among the team members.

Assessing team member empowerment derived from organizational structure.

Identifying key actions that should be taken by team members to ensure that patients receive quality and safe care. The key actions should also ensure the safety of team members during fieldwork.

Evaluating potential multicultural and diversity issues team members may encounter in the host country.

Evaluating potential power conflicts that may arise when dealing with a multinational contingent.

Stakeholders Affected by the Mobilization Plan

Major stakeholders affected by the mobilization

Organizational leadership and management staff

Investors

Nursing leadership and professionals

Physicians

Patients

How does mobilization impact staffing and care patterns in the medical Center?

It will cause shortage of staff.

Major stakeholders affected by the mobilization are as follows:

Organizational leadership and management staff

Investors

Nursing leadership and professionals

Physicians

Patients

As a recognized medical Center known for its research studies on and treatment of contagious diseases, the organization is suitable for the medical mission.

How does mobilization impact staffing and care patterns in the medical center?

It will cause shortage of staff. As 20 NPs will be reassigned to the mission, the impact on nursing departments will be

Longer shift hours among NPs

High frequency of floating

Imbalance in nurse-to-patient ratio

Increased workload on NPs

According to systems theory, an organization is a collection of different parts that work in tandem to achieve organizational goals. However, changes in any one part can cause changes or affect the functioning of other parts as well (Huber, 2017). Therefore, organizational changes like mobilization of health care staff from different professional areas—administration, nursing, and medicine—will impact other areas of the medical center.

Organizational leadership, management staff, and investors will have to manage the medical center with fewer administrators, which will cause problems during allocation of resources and maintenance of facilities.

In the clinical setting, the shortage of NPs and physicians will affect patient outcomes as patients depend on their nurses and physicians to provide quality and safe care. According to Huber, when the number of NPs on a shift is high, patients are more satisfied because they can easily approach NPs for care-related problems. Increased approachability also empowers patients.

The medical center in this scenario is one of foremost centers in the United States known for its research studies on and treatment of contagious diseases. The organization’s health care professionals are experts who can help the African nationals affected by the viral contagion. Also, health care organizations have an obligation to use their human and material resources to help disadvantaged populations within and outside their community (Hawkins, 2013).

Other factors that make the medical center suitable for the medical mission is its achievement of Magnet recognition.

Incorporating the standards of Magnet, the organization has established shared governance in its leadership and management styles.

Its health care professionals show high-levels of autonomy, shared decision-making, and evidence-based practice and are capable of systematically solving organizational issues.

Magnet recognition improves organizational performance by (a) changing personnel policies and programs, (b) focussing on professional development, (c) improving relationships between community and health care organizations, and (d) improving the image of nursing (Luzinski, 2012).

The diversion of human resources from the medical center to the mission can cause a severe staff shortage. The nursing department will be affected the most because it will have to fill 20 positions to manage day-to-day tasks efficiently. Shortages in staff have been tied to problems such as negative patient outcomes; job dissatisfaction among health care professionals: NPs, physicians, and clinical technicians; decreased productivity of workforce, and disorder in the health care organization (Currie & Carr Hill, 2012). According to systems theory, problems in staffing will affect processes and structures in other departments of the medical center. Also, since all health care professionals depend on NPs to accomplish patient-related tasks, a shortage of nursing staff can affect patient care and administration of treatment.

Longer shifts for nurses can cause burnout (Huber, 2017). Shifts of more than nine hours affect the efficiency of NPs and will negatively affect their motivation to stay in the medical center, causing job dissatisfaction.

Floating is the redistribution of NPs from overstaffed units to understaffed units. However, floating is not possible when NPs have been mobilized for a medical mission, as all units face a shortage of staff (Huber, 2017).

Patients are assigned to NPs after careful planning and assessment of the workforce. If NPs are assigned too many patients, they may not be able to give equal quality of care and safety to all patients, which in turn may lead to negative patient outcomes (Huber, 2017).

During nurse shortages, existing nursing workforces are forced to fill the empty positions by taking up extra work. However, too many patient assignments, long shift hours, and inability to manage different duties can cause job dissatisfaction and even lead to harmful patient care practices (Huber, 2017).

Impact of Mobilization on Staffing and Care Patterns (2/2)

Strategies to maximize staffing and maintain high level of patient care:

Recruitment of NPs.

Unit size

Leadership styles

Retention strategies

Shared governance model of nursing management (Currie & Carr Hill, 2012).

Organizational decisions such as the mobilization of staff are often the underlying factors behind problems in nurse staffing and delivery of patient care (Currie & Carr Hill, 2012). Ignoring these factors can worsen problems, as described by studies on systems theory effects on health care. In fact, the causes of systems problems vary every time. Therefore, strategies devised to mitigate problems must be flexible and must target the identified individual causes. The strategies described here take into account the changing nature of organizational systems and help nursing professionals adapt to problems.

Recruitment and retention strategies: The medical center should recruit more NPs to fill the gaps in nursing practice. It can strategize by targeting young professionals. Young or newly graduated NPs show better adaptability in nursing practice and are more satisfied with their job. In parallel, the medical center should also invest in retention strategies targeted at older NPs, who are more likely to retire or change jobs when dissatisfied with the work environment (Currie & Carr Hill, 2012). Retention strategies include providing opportunities for professional growth through training, setting up communication lines that allow NPs to express any work-related grievances, allowing sharing of workload among nurses, and assigning mentors to NPs so that they can better adapt to organizational change (Huber, 2017).

Unit size: Reorganizing nursing teams into smaller, but numerous autonomous teams within different units might improve staff conditions and avoid dissatisfaction, and mitigate turnover (Currie & Carr Hill, 2012). This is because smaller teams are better able to practice shared governance and decision-making in quality and safe patient care.

Leadership style: Managing staffing and care patterns are important nursing leadership duties. However, in order to execute staff management policies, nurse leaders have to develop effective leadership styles (Huber, 2017). Studies have shown that relational leadership styles, which focus on building productive relationships with people, have helped nurse leaders implement effective staff management strategies. Relational styles also develop authenticity in a nurse leader’s work, which is essential for building strong teams. A leader who develops authenticity in his or her work, builds trust, shares information and communicates with team members, and motivates staff to achieve organizational and health care goals. These leadership activities further empower NPs (Körner, Wirtz, Bengel, & Göritz, 2015).

Shared governance models: Distributing power among nurses allow NPs to make decisions to improve their units and productivity such as self-scheduling tasks or sharing workload without seeking approval from organizational leaders. Shared governance also improves job satisfaction and the self-worth of NPs by granting more autonomy (Currie & Carr Hill, 2012).

Organizational Structure of the Medical Mission Team

Characteristics of the organizational structure:

Shared governance model:

Lean and decentralized

Shared distribution of governance and management

Autonomy and independence

Nonhierarchical model:

Leaders do not have the final decision-making power. That power is equally distributed among all health care professionals—administrators, NPs, and physicians.

Team members will be structurally empowered during mission duties (Wong & Laschinger, 2014).

Conflicts often arise in medical mission teams because of communication gaps and the lack of clarity on individual roles, communication gaps. Some members may also feel they have less power compared to other team members (Currie & Carr Hill, 2012). To instill unity in the mission team, leaders from all three fields—medicine, administration, and nursing—must collaborate with other team members and share leadership roles and responsibilities.

The shared governance model emphasizes decentralized and lean forms of governance. It encourages NPs to be autonomous and independent from the influence of physicians and administrators. Leadership roles are equally distributed among team members (Currie & Carr Hill, 2012).

Therefore, power is not concentrated to a few leaders in the team. All team members have the power to make decisions about their work and patient care. However, they should ensure that health care standards such as evidence-based practice, quality of care, and patient safety are maintained.

The distribution of power also allows team members, especially NPs, to develop leadership skills themselves. In a multinational effort, NPs who are allowed to participate in patient care rounds, organize resources and staff, and consult with other health care professionals are able to grow professionally (Currie & Carr Hill, 2012).

The decentralization of power structures also implies lack of hierarchy in health care practice. Leaders in the mission team have the practical purpose of being points of contact for other teams in the multinational effort. However, all information gathered during meetings with multinational teams is shared with the NPs, administrative staff, and physicians. Decisions made have the combined input from all team members.

The shared governance model also allows the team to become structurally empowered. Structural empowerment is the presence of social structures such as autonomy and leadership that enable health care professionals to accomplish work in meaningful ways. Structurally empowered NPs have access to educational and professional development resources, information about policies and goals, and opportunities to contribute and execute ideas, without the need for multiple layers of approval (Wong & Laschinger, 2014).

Organizational Structure of the Medical Mission Team

Leadership

Team members

The mission head or mission coordinator is the first level of leadership. The main roles include coordinating efforts with and being the point of contact for leaders from other multinational teams. The mission head’s decision-making processes involve the administrative head, nurse leader, and physician leader, as well team members. Mobilization plan for the international medical mission.

The administrative head is the point of contact for the administrative team. He or she is responsible for working with the mission head to manage resources and staff, and establishing communication lines.

The nurse leader is responsible for managing nursing resources and staff and coordinates with the mission head to organize nursing teams for clinical duties. The nurse leader also supervises the 20 NPs assigned to the mission team. Mobilization plan for the international medical mission.

The physician leader manages doctors on clinical duty, assigns clinicians to rounds, and coordinates with the nurse leader and NPs on patient assignments and treatment. Mobilization plan for the international medical mission.

All team members work closely together and communicate frequently, while providing regular reports to the field leaders and the mission head. This is done to prevent wastage of resources, and to manage time and costs effectively. Mobilization plan for the international medical mission.

Leadership is essential to this scenario as he or she helps mobilize teams to action and represents the team in the multinational effort. However, the power to make decisions is not centralized to leadership. It is distributed among all team members. Information that leaders gather during meetings with other leaders are shared with team members, who will in turn provide feedback or ideas. Mobilization plan for the international medical mission.