Running head: ORIENTATION PROPOSAL
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Management Orientation Proposal
Stacey Magee
American Sentinel University
ORIENTATION PROPOSAL
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Management Orientation Proposal
The purpose of this paper is to propose an orientation program format for the hospice program supervisors and managers. The
format chosen will provide a self-directed orientation and serve as an ongoing reference tool. This program will enhance the current
orientation process which lacks structure and self-direction.
Nurses deserve a purposeful, meaningful orientation that is specific to their specialty (Sims & Bodnar, 2012). At UC Davis we
worked collaboratively to develop shared nursing core competencies that are included in hospital orientation but then the expectation
is to have nursing orientation be department specific for ambulatory nursing and home care. Nursing orientation should include
essential and related information about quality care, safety, infection control, ethics, assessments, emergency response, regulatory,
licensing and accreditation information, policies, and procedures and shared governance (Sims & Bodnar, 2012). Health care is
constantly changing and an effective orientation program must provide learners with current information and tools related to their
specialty (Sims & Bodnar, 2012).
Topic
Directs and supervises
clinical staff
Rationale for Inclusion
Objectives
Nurse leaders need to be 1. Nurse leader will be able to
able to create, share a
demonstrate understanding of
vision, set an example
developing an effective plan of care
and resolve conflict
and monitoring and evaluating
(Moss, 2005).
patient care outcomes.
2. Nurse leader will be able to support
staff’s ability to meet required
performance and competency
standards
Resources
Hospice policy: 751.5 Supervision
http://www.hr.ucdavis.edu/sdps/onb
oarding-toolkit-supervisorsguide/first-week/first-weekorientation
ORIENTATION PROPOSAL
Topic
Primary resource and
mentor to new nurses
Staffing and scheduling
Nursing evaluations
1. Probationary period
2. Performance
Management
3. Employee
Recognition
Hospice referral
coordination
Hospice contract services
1. Pharmacy
2. Transportation
3. DME
4. Supplies
3
Rationale for Inclusion
Objectives
Nurse leaders need to be 1. Nurse leader will be able to support
able to create, share a
staff’s ability to meet required
vision, set an example
performance and competency
and resolve conflict
standards
(Moss, 2005).
Staffing a hospice
program should be
based on characteristics
of the patient served,
environmental
considerations and staff
competence (NHPCO,
2013)
Employee evaluations
are an opportunity for a
manager to identify
good practice and
opportunities for
improvement
(Stonehouse, 2013)
Orientation should be
specific to the nurse’s
specialty (Sims &
Bodnar, 2012)
Orientation should be
specific to the nurse’s
specialty (Sims &
Bodnar, 2012)
1. Nurse leader will develop schedules
to meet patient care need and
nursing productivity standards
2. Nurse leader will be able to create
and oversee a fair staff schedule
based on staffing, patient care needs,
acuity and competency of staff.
1. Nurse leader will complete annual
evaluations for direct reports.
2. Nurse leader will provide feedback
to indirect reports annually.
3. Nurse leader will utilize employee
recognition program.
1. Nurse leader will be able to
coordinate referrals taking into
consideration hospice admission
criteria and goals of care
1. Services provided based on
formulary or interdisciplinary team
process
2. Medication cost meets budgeted
expense
3. Other contract services meets
budgeted expense.
Resources
Hospice policy: 751.7
Requirements for
Supervisors/Preceptors
http://www.hr.ucdavis.edu/sdps/onb
oarding-toolkit-supervisors-guide
Hospice Policy: 751.1 Hospice
Personnel Plan/Staffing
http://www.nhpco.org/sites/default/
files/public/quality/Staffing_Guidel
ines.pdf
Hospice policy: 754.1 Performance
Evaluations
http://www.hr.ucdavis.edu/sdps/onb
oarding-toolkit-supervisorsguide/first-year/first-yearperformance-management
http://www.nhpco.org/hospiceeligibility-requirements
http://www.nhpco.org/regulatory/bi
lling-and-reimbursement
ORIENTATION PROPOSAL
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Topic
Hospice insurance and
reimbursement
1. Medicare/Medicaid
2. Private Insurance
3. Donated Funds
Hospice external
regulations
1. Medicare Conditions
of Participation (CoP)
2. Hospice State
Standards
3. The Joint
Commission
4. HIPAA
Rationale for Inclusion
Objectives
Orientation should be
1. Program will be reimbursed for care
specific to the nurse’s
provided.
specialty (Sims &
2. Bad debt will meet or exceed budget
Bodnar, 2012)
Resources
http://www.nhpco.org/regulatory/bi
lling-and-reimbursement
1. Program meets Medicare CoP’s,
Joint Commission standards and
state licensing standards.
2. Programs maintains hospice license
by the state and federal government.
3. Program maintains accreditation by
Joint Commission.
4. Nurse leader ensures HIPAA
compliance is maintained.
http://www.nhpco.org/regulatory/bi
lling-and-reimbursement
Information Systems:
Electronic Medical
Record
Technology supports
point of care assessment
and care planning along
with available resources
(Tapper, et al, 2012)
Human relations is
ranked one of the most
important characteristics
of a nurse manager
(Dienemann & Shaffer,
1993)
Human Resources
1. Leave/time off
2. Holidays
3. Violence in the work
place
4. Sexual harassment
Orientation should be
specific to the nurse’s
specialty (Sims &
Bodnar, 2012)
1. Documentation will reflect patient
status and patient care provided
2. Documentation will meet regulatory
requirements
1. Nurse leader will demonstrates
ability to manage scheduling and
time off requests while meeting
departmental needs.
2. Nurse leader will demonstrates
awareness of appropriate work place
behavior.
3. Nurse leader will ensure employees
are current with annual mandatory
violence in the work place and
sexual harassment training.
https://www.cms.gov/Center/Provid
er-Type/Hospice-Center.html
http://www.cms.gov/Regulationsand-Guidance/HIPAAAdministrativeSimplification/HIPAAGenInfo/inde
x.html
http://www.ucdmc.ucdavis.edu/him
/
http://intranet.ucdmc.ucdavis.edu/e
mr/
Hospice policy: 755.1a. Use of Paid
Time Off
http://www.hr.ucdavis.edu/employe
e/leave-time-off
http://www.hr.ucdavis.edu/supervis
or/Er/Violence
http://shep.ucdavis.edu/
ORIENTATION PROPOSAL
Topic
Performance
Improvement
1. Lean Six Sigma
2. DMAIC
3. PDSA
4. QAPI
Hospice specialty
services
1. We Honor Veterans
1. Pediatrics
2. Volunteer
3. Bereavement
Infection Prevention and
Control
5
Rationale for Inclusion
Objectives
Quality improvement
1. Nurse leader will complete one
initiatives can result in
performance improvement project
improved care for the
each year utilizing an approved
dying (D'Onofrio,
format.
2001).
2. Patient and programmatic outcomes
will meet or exceed departmental
goals.
3. Patient and programmatic outcomes
will be benchmarked with state and
national outcomes.
Orientation should be
1. Nurse leader will assist with
specific to the nurse’s
obtaining level 3 We Honor
specialty (Sims &
Veteran’s status by 2015
Bodnar, 2012)
2. Nurse leader will ensure program
meets program goals specific to
services provided
Infection prevention in
the home includes hand
washing, environmental
cleanliness, isolation
precautions and use of
protective equipment
(Jeanes & Swanson,
2013)
1. Infections will be tracked, trended
and reported annually.
2. Catheter associated urinary tract
infections (CAUTI) and central line
associated blood stream infections
(CLABSI) will be reported
separately.
Resources
http://intranet.ucdmc.ucdavis.edu/cl
inops/resources/performance_impro
vement.shtml
http://intranet.ucdmc.ucdavis.edu/cl
inops/data/performance_improveme
nt/DMAIC_and_PDSA_2011.pdf
http://www.nhpco.org/quality
http://www.wehonorveterans.org/
http://www.nhpco.org/resources/pe
diatric-hospice-and-palliative-care
http://www.nhpco.org/education/vo
lunteer-and-volunteer-management
http://www.nhpco.org/resources/gri
ef-and-bereavement
Hospice policy: 850.1 Infection
Control and Prevention Plan
http://www.cdc.gov/
ORIENTATION PROPOSAL
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Conclusion
Nurses require an orientation and competency program specific to their specialty in order to be successful. Nursing leaders
similarly require an orientation program specific to their specialty, supervision and management. With this new tool, UC Davis Home
Care will be able to provide a self-directed orientation program and provide supervisors with a reference tool for continued success.
ORIENTATION PROPOSAL
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References
Centers for Disease Control and Prevention. (n.d.). www.cdc.gov
Centers for Medicare and Medicaid Services. (n.d.). http://www.cms.gov/
Dienemann J, Shaffer C. (1993). Nurse manager characteristics and skills: curriculum implications. Nursingconnections.
Summer;6(2):15-23.
D'Onofrio, C. (2001). Hospice quality improvement programs: an initial examination. Journal Of Nursing Care Quality, 15(4), 29-47.
Health Insurance Portability and Accountability Act, Title II U.S. Department of Health & Human Services § (1996).
Jeanes, A., & Swanson, J. (2013). Simple and consistent infection prevention. Nursing & Residential Care, 15(10), 646.
Moss, M. (2005). The Emotionally Intelligent Nurse Leader. San Francisco, CA: AHA Press.
National Hospice and Palliative Care Organization. (n.d.). www.nhpco.org
National Hospice and Palliative Care Organization. (2013). Staffing guidelines for hospice home care teams. Retrieved from
www.nhpco.org/staffing-guidelines
Sims, M., & Bodnar, G. (2012). Adding value to nursing orientation for ambulatory care nurses. AAACN Viewpoint, 34(4), 4-7.
Stonehouse, D. (2013). Appraisal: a key tool to delivering quality care. British Journal Of Healthcare Management, 19(7), 338-341.
Tapper, L., Quinn, H., Kerry, J., & Brown, K. (2012). Introducing handheld computers into home care. Canadian Nurse, 108(1), 2832.
The Joint Commission. (n.d.). http://www.jointcommission.org
ORIENTATION PROPOSAL
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UC Davis Center for the Professional Practice of Nursing. (n.d.).
http://www.ucdmc.ucdavis.edu/cppn/professional_connections/emerging_nurse_leaders.html
UC Davis Health System Finance. (n.d.). http://intranet.ucdmc.ucdavis.edu/finance/
UC Davis Health System Human Resources (2012). Supervisors tool kit. http://www.ucdmc.ucdavis.edu/hr
UC Davis Health System Health Information Management. (n.d.). http://www.ucdmc.ucdavis.edu/him
UC Davis Health System Infection Prevention. (n.d.). http://intranet.ucdmc.ucdavis.edu/infectioncontrol/
UC Davis Home Care. (2009). 751.7 Requirements for supervisors and preceptors [policy]. Sacramento, CA: UC Davis Home Care.
UC Davis Home Care. (2009). 751.1 Performance evaluation [policy]. Sacramento, CA: UC Davis Home Care.
UC Davis Home Care. (2009). 850.1 Infection control and prevention plan [policy]. Sacramento, CA: UC Davis Home Care.
UC Davis Home Care. (2009). 755.1a. Use of paid time off [policy]. Sacramento, CA: UC Davis Home Care.
UC Davis Home Care. (2009). 755.5 Supervision [policy]. Sacramento, CA: UC Davis Home Care.
We Honor Veterans. (n.d.). http://www.wehonorveterans.org/
World Health Organization. (n.d.). http://www.who.int/en/