One of the biggest leadership issues is identifying gaps in the healthcare system and
finding ways to close those gaps.
In my opinion an area which contributes to a
in the health
is lack of knowledge, specifically the l
ack of knowledge
that is associated with
patient safety. Finding a way to fill this gap is a priority of this writer. It is also a priorit
this writer to be a good leader. An organization must have good leaders in order to be effective.
Organizations must have a mission, vision and values.
The Albatross Health System’s
mission is to help people live healthier lives and to help
make the health system work better for
everyone. The values are integrity, compassion, relationships, innovation and performance. It is
a leader’s responsibility to help the staff live up to this mission and to live the values in and out
of work. Leade
rship priorities are needed to not only live up to the mission, but to help staff
understand what it takes to live the values.
The purpose of
this paper is to focus
one main nursing priority that is
in need of
improvement. It wi
ll also offer
to this issue
It will show how improving this
can have the ultimate positive result
healthy patient. The
ty this paper
will focus on is
lack of education to both
and the patients
his paper will fo
only on healthcar
e in general, but specifically o
n chronic kidney disease (CKD) and end stage
renal disease (ESRD) and a telephonic program designed to help these patients live healthier
lives. Having a telephonic program in place can lead to grea
ter outreach than in person
This paper will show how the organization of this writer is in line with the goal of
improving the level of education for the patient as well as providers.
In order to be an effective leader, it is necessary to have
the appropriate resources and
tools. There are different forms of leadership that work well as resources. This paper will focus
on transformational leadership and transactional leadership as tools. Leaders also must have
resources such as seminars, a
which are mini courses with
are mandatory, but there are a multitude of them that are not, and
they are there solely to allow an employee to build knowledge and become more proficient.
this paper will also take a look at how multiculturalism and diversity play a role in
helping the telephonic program be effective. It will show how the organization values all culture
makes it a goal to include this in the education.
The lack of education in healthcare can be harmful. The lack of education in chronic
kidney disease (CKD) and end stage renal disease (ESRD) can be fatal. “Preparation for end
stage renal disease (ESRD) is widely acknowledged to be suboptimal in the Unit
(Kurella, Li, Chen, Cavanaugh, Whaley
Connell, McCullough & Mehrotra,
, p 686).
According to Lopez
Vargas, Tong, Phoon, Chadban, Shen, and Craig (
), the lack of
knowledge in CKD and ESRD patients can cause the patients to deny their di
sease leading to
With CKD on the rise, it is important to educate Americans on the causes, risk factors,
preventative care, and signs and symptoms to look for. The problem is, there are many doctors
who are not honest with their patie
nts or they simply do not understand the consequences or risk
factors of CKD themselves. Diabetes Mellitus (DM) is one of the major risk factors for CKD
along with Hypertension (HTN). According to McK
inlay, Piccolo, and Marceau (1994
percent of do
ctors did not diagnose DM when there were many symptoms present. In
was estimated that 285 million people were diagnosed with DM and it was projected that by
2030 that number would increase to 439 million. This is extremely important to CKD since
a major risk factor. In order to prevent CKD from developing in these diabetic patients, the
patients must be educated about the symptoms and the providers must be educated to screen for
DM and recognize the symptoms.
There are programs offered
by many organizat
ions such as this writer’s organization that
are free of charge for patients as part of their insurance benefits. These programs educate on
signs and symptoms of CKD as well as
diabetes mellitus (
mostly telephonically, in regard to preventative measures such as diet, exercise, and
avoidance of certain over the counter (OTC) medications including avoidance of intravenous
contrast dye. It is important to make sure diabetics are monitoring their blo
od glucose, and
patients with HTN are monitoring their blood pressure and recording the results to bring to the
In today’s very sophisticated, complicated world, technology is no stranger to most
people. However, it is slow to be acce
pted in healthcare education. It is widely used for college
courses, such as this one, where all classes are solely web based, but when it comes to using
technology to reach its employees and also its patients, it could be used so much more.
s the delivery of health care services at a distance, using information and
communication technology” (Wade, Karnon, Elshaug, & Hiller,
, p. 1). According to
Wade, Karnon Elshaug and Hiller (
) telehealth can be used with video in real time. This
could be such a great tool, not only for the patients, but also for the staff. This writer has a staff
that is spread over several states. Imagine the impact telehealth programs brought directly to
smart phones or tablets could have. Imagine the impact
those nurses using that technology could
then have on the patients.
One of the issues that this writer encounters is a language barrier. In a telephonic
program, this can cause some very big problems. Many times our nurses use language lines as
ters and this does help, but it does not solve the problem completely since it can be
distracting having a question relayed through an interpreter. So how do we effectively solve this
problem? One of the suggestions of this writer and nurse is to hire a
ince there is
a lack of ethnically diverse nursing faculty as well,
encouraged for all faculty” (
, p. 136). This could solve a very large gap in the
Plan of Act
The values of
Health Care are integrity, compassion, relationships, innovation
and performance. These values need to be taken into consideration when planning a solution to
the lack of education in CKD and ESRD patients. The use of technology a
nd hiring a diverse
of nurses has to be part of the telephonic program. The values and structure of
needs to be taken into consideration.
mission is to help people live healthier lives. This fits
in with this writer’s plan to use a telep
honic program to close the gap in education provided to
CKD and ESRD patients as well as their providers.
If the patients are suffering from a lack of knowledge, a good leader must empower the
staff to educate the patients. How is that done? It is do
ne by educating the staff so they can then
educate the patients. “Low adherence to chronic kidney disease (CKD) guidelines may be due to
unrecognized CKD and lack of guideline awareness on the part of providers” (Drawz, Miller,
Singh, Watts, & Kern, 2
. In this case, who are the providers? It is the nurses. Leaders must
seek out the appropriate resources for their staff. Using professional organizations can help.
“Professional nursing organizations can make substantial contributions to the move heal
quality forward by providing EBP work
shops similar to those conducted by the American
Nephrology Nurses’ Association” (Hain,
), a transactional leader is a manager or leader who also
can be seen as a
caregiver. They set goals for their staff and then reassess on a daily basis using
individual goals based on the employee’s personal ability. A transformational leader, however,
according to H
), provides a sense of direction for the staf
f motivating them to
their full potential. “Transformational leadership is believed to operate through four distinct, but
closely correlated, components of leader behavior, which encourage employees to exceed
expectations in terms of their own behavior” (
, p. 26).
How do either of these leadership styles act as a tool for good leadership that can help
with the priorities of education?
The right leader for the right group is extremely important.
Staff responds differently to different leader
s. Being a fairly new manager has taught this writer
that a combination of all leadership styles is best, and it is sometimes necessary to use different
styles with different employees. It is extremely important to know your own leadership style so
an provide your staff with the resources they need to be effective.
According to H
, there are many leadership theories that are grouped in
three types including trait, attitudinal and situational.
The trait approach of leadership identif
certain characteristics of a leader.
The attitudinal approach looks at the attitude of the leader and
the situational looks at observed behavior.
To address the
lack of education problem,
I think a combination of all of the leadership
should be used together.
A leader has to set a good example.
The saying do as I
say not as I do does not apply here.
The Leader must expect that the staff will do what they do.
If a leader has a bad attitude, so will the staff.
If a leader has a bad b
ehavior, so will the staff.
This all has to be taken into consideration when developing a program.
Performance Evaluation Plan
In order to know if my plan has been effective, I will put a performance evaluation plan
into effect. I will use before and after data to determine the increase in education by using the
test/post test process. I am currently looking through the lit
erature to find a reliable data
collection tool. I will compare the data to determine if the hospitalizations have decreased.
Have the deaths decreased? Are the patients living healthier lives? All of this will be considered
when comparing before and a
My career goal is to become a nurse researcher which means I will eventually have to earn a
Ph.D. I’m starting now by implementing this performance improvement project at my hospital.
The biggest obstacle I will face in my envir
onment is finding a mentor. We currently do not
have a formal research department.
ack of education is a leadership priority
and this writer take very
seriously. Having the proper resources and choosing the proper lead
ership style can make the
difference of a successful leader and a not so successful leader. In order to fulfill our mission,
vision and values, we must know what they are and lead the staff to live up to them. CKD and
ESRD are used in this paper as an ex
ample since this is the current experience of this writer,
however all fields of healthcare can benefit from these priorities. Using technology to educate
staff, and also patients is an element of nursing
that is becoming more popular.
based learning is a great way to reach employees who can’t or d
on’t use in person seminars
All of these things together can make a great program even
An evaluation of the effectiveness of this program is also
an integral part of the program.
The knowledge if the program is effective is vital to the success of the program. The ultimate
goal is a healthier patient. This telephonic program can make that difference