Block 1: Preliminary Activities
Elements of the LLE Project:
The documentation of your LLE is a project that will be included in your professional e-portfolio. This project should show you at your best and demonstrate your leadership competence. The project will include the following steps:
- Identify the problem or issue that you want to address. – ambulatory care nursing…
- RNs and Mas are refilling prescriptions for doctors for patients that have not been seen by their PCP or Specialty provider in the last year. There is no standing order that blankets all of UT Physicians here in Houston, Texas.
- Research what is already known about this issue.
- Develop a written proposal of a solution.
- To write a policy that states that the doctors will need to approve medication refills prior to the MA or Nurse fulfilling the requests for refills
- Enhance your proposal with resources, consideration of stakeholders, an implementation plan, an evaluation plan, etc.
- Stakeholders will be – Katerina Wings RN MSN (my Safety Director for UT Physicians) and Andre House Senior Vice President and COO for final approvals. And two nurses to review the written policy prior to the directors signing off and sending to VP for final. (our process for policy and procedure)
- Personal reflection about the project. I rock LOL – patient safety and protection for the company and staff is very important to me.
- Verification from a resource person (leader). Got this
- Assemble and refine all project components.
- Submit the full project.
You’ll need to decide on the limits of your project since you can’t solve all of the world’s problems at once.
Read through the following case study focused in the policy area to see how the process of choosing a subject might work. This example shows how to think through the whole process, although for now, you will only need to identify your problem situation.
This example shows how to think through the whole process of choosing a subject. The situation could be approached with a policy, practice, population, or education solution. The student in this example has chosen to focus on developing policy, although he/she could have selected any of the other three areas also. Regardless of whether the choice is policy, practice, population, or education, the questions asked in the case study serve to help the student decide if it is feasible to develop a proposal to address the situation.
Now, identify a problem or issue that you seek to solve. You may need to meet with your organizational resource person to help choose a current problem or issue, as he/she will need to attest to the importance of your topic to the organization on the Professional Verification Form (located in the Professional Verification Form section below). Write out a mind map to show relationships and the extent of the problem you will investigate as you choose your project topic. You might include:
- What is the topic you choose? Policy
- Why is it important to you, to nursing etc.? Protect the patient, protect the docs, protect the staff members as well – streamline the process company wide.
- What is the ultimate goal your hope to accomplish? Ultimately, I want to protect everyone involved.
- Why is this relevant? Because that is my purpose as a RN – protect and educate all parties involved to prevent slips, errors, and injuries/fatalities.
Background Research:
Do some serious research about the problem you’ve selected. Find and document evidence answering the following questions:
- Why is this issue important, timely, and relevant to your current situation?
- Are there articles in professional journals about this topic?
- Are there recommendations from professional organizations about this topic?
Write up your background research as a part of your project submission.
- Discuss your investigation of the problem or issue. Describe the sources of information within your organization that you investigated and provide evidence from these sources to substantiate the problem or issue (e.g. organizational assessment, national source documents, evidence from a stakeholder).
- Analyze the state of the situation using current data. Analyze those things that might be contributing to the problem or issue.
- Be sure to include all in-text citations and references in APA format.
- The submission MUST include APA formatted in-text citations with a corresponding reference list for any direct quotes or paraphrasing when using sources to support ideas and elements in a paper or project. It is not necessary to list sources that were consulted if they have not been quoted or paraphrased in the text of the paper or project. Use of “personal communications” sources require specific rules. Consult APA resources for these.
- No more than a combined total of 30% of a submission can be directly quoted or closely paraphrased from outside sources, even if cited correctly. Please refer to the APA Handout web link included in the APA Guidelines section for tips on using APA style.
Proposing a Solution:
You will now propose a realistic and measurable solution or innovation for the problem or issue. You will need to:
- justify your proposed solution or innovation based on the results of your research investigation and analysis
- include a basic plan of how to implement your solution in your environment
- consider the proposed solution from the viewpoint of the manager of the healing environment
- consider the expected impacts of your proposed solution as well as possible unanticipated consequences
Work through the following case study to see what questions can be asked to help formulate a solution. In this example the student chose a Practice change solution to the situation, although he/she could have selected any of the other three areas also. The questions asked in the case study serve to help the student decide how to formulate the solution regardless of whether the choice is policy, practice, population, or education.
Write up your proposed plan not only as a part of your project submission but also for review by a leader in your organization. Further activities within this course will help with some specific details that will need to be included.
Choosing Your Subject:
Policy (my chosen topic)
Developing, explaining, or acting on policies that emanate from legislative, regulatory, and professional practice. This sphere has high visibility and high impact across a wide area.
For example:
- rule development
- high-level professional nursing organizations
- legislation or testimony related to a nursing practice
- regulations from state boards
- the process of policy development
Block 2 Leadership Learning Experience
Details of Your Solution:
Any implementation of a project will require resources. Think broadly about resources in all of the following areas.
Time
- to develop the project
- to instruct others in the changes to their workflow
- to get staff up to speed using the new function
Materials
- for the project itself
- to communicate the changes to others
- that may be unused or wasted from current practices
Personnel
- for changes in their work environment
- who actively oppose your implementation
- for more staff
- for reduced staff
- for those no longer needed
Money
- for materials as noted above
- for additional staff training and lost time for them at work
- to pay more/less highly educated staff
Key Stakeholders:
The term “stakeholders” refers to those who have a stake in the success of your proposal or who have the ability to influence its outcome. Identify key stakeholders and/or appropriate partners that are important for the implementation of your solution or innovation.
- Discuss why each key stakeholder and/or appropriate partner is important for the implementation of the solution or innovation.
- Summarize your engagement with each key stakeholder and/or appropriate partners, including the input and feedback you received.
- Discuss how you intend to work with each of those key stakeholders and/or appropriate partners in order to achieve success.
Implementation Plan:
Write a clear plan of how your proposed solution or innovation would be implemented. Use the plan to answer the following:
- Who will need to give authorization to implement the proposal?
- Who will be needed to train others or actually do the implementation?
- Who will need to be trained in the new practices?
- How will you communicate with all these people?
- How will you communicate with those who will be impacted even if they don’t participate (e.g., patients)?
- What is the timeline for each step of your implementation plan based on your proposal?
- What are the criteria to judge success of the proposal?
Evaluation Plan:
Evaluation of a project must be included in the original plan. That evaluation includes both how you will gather data about the impact and outcomes of the project and the criteria for success. Work through the following case study to see an example of what to include in your evaluation plan.
The student in this example chose an education solution to the problem of implementing SBAR communication. Regardless of whether the solution is policy, practice, population, or education, the evaluation plan includes at least one measurable criterion for success and a description of how it will be obtained.
You should now put this information together with the project you have chosen. Begin to lay out the process to plan your solution and the implementation of the solution. Be sure that your written plan is clear and covers the project in detail. Your project should include everything that would be required to actually implement this solution, although you may not have authority in your current practice.
Cost Benefit Analysis:
Include a cost benefit analysis of your proposed solution or innovation. For more detailed instructions on providing details of your solution, including a cost benefit analysis and money matters, review the following chapters in the e-texts indicated:
- Schmidt and Brown: Chapter 16 (“Teaching Evidence-Based Practice in Academic Settings”)
- Melnyk and Fineout-Overholt: Chapter 9 (“Implementing Evidence in Clinical Settings”)
- Cost-Benefit Analysis
Include a specific section or table in your project to discuss the resources needed for your project.
Professional Roles Reflection:
Review the following document:
Examine the definitions of the three professional nursing roles. Explain how you fulfilled the following roles during your process of investigation and proposal development:
- scientist
- detective
- manager of the healing environment
Your reflection needs to cover:
- What (What was the problem?)
- How (How did you investigate the problem?)
- When (How long did you investigate the problem?)
- Why (Why was the problem of interest to you, your facility, or healthcare community?)
- Who (Who were your team members and why?)
Your reflection may also include:
- What responses did you get from others related to your topic?
- Who did you seek feedback from? (Name, title, role)
- Why did you seek feedback from this person?
- Did any of the feedback you received surprise you? Why?
- Rubric (all elements are addressed and information is consistent).
Read the following case study of a student’s reflection on a project in the population area: Case Study Example: Professional Roles Reflection
This example illustrates how the student reflected on a project related to a specific patient population. Regardless of whether your proposal focused on policy, practice, population, or education, the reflection must include how the student fulfilled each of the three professional roles as he/she developed the proposal for a solution.
Summarized with the Task Requirements:
A. Develop a written proposal by doing the following:
1. Identify a problem or issue related to practice, policy, population, or education that aligns with the organizational priorities you seek to solve.
Note: You may need to meet with your organization or practice setting, your manager, or your supervisor to help choose a current problem or issue.
a. Explain the problem or issue, including why it is applicable to the area of practice you chose and the healthcare environment.
2. Discuss your investigation of the problem or issue.
a. Provide evidence to substantiate the problem or issue (e.g., organizational assessment, national source documents, evidence from a stakeholder).
3. Analyze the state of the situation using current data.
a. Analyze areas that might be contributing to the problem or issue.
4. Propose a solution or innovation for the problem or issue.
a. Justify your proposed solution or innovation based on the results of your investigation and analysis.
5. Recommend resources to implement your proposed solution or innovation. Include a cost-benefit analysis of your proposed solution or innovation.
6. Provide a timeline for implementation based on your proposal.
7. Discuss why each key stakeholder or partner is important for the implementation of the solution or innovation.
a. Summarize your engagement with the key stakeholders or partners, including the input and feedback you received.
b. Discuss how you intend to work with those key stakeholders or partners in order to achieve success.
8. Discuss how your proposed solution or innovation could be implemented, including how the implementation could be evaluated for success.
B. Explain how you fulfilled the following roles during your process of investigation and proposal development:
1. scientist
2. detective
3. manager of the healing environment
C. Submit the completed attached “Professional Verification Form” from the organizational leader advising you in your leadership experience.
D. Acknowledge sources, using APA-formatted in-text citations and references, for content that is quoted, paraphrased, or summarized.
E. Demonstrate professional communication in the content and presentation of your submission.
