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The Transformational Model for Professional Practice in Health Care Organizations

Overview
The Transformational Model
The Professional Practice Component
The Process Component
The Primary Outcome Component
The Strategic Outcome Component
Implementation of the Model
Applications of the Model
Implementation Outcomes
Printable Documents

Overview

As the world of health care continues to evolve, those responsible for providing care must look at their roles and practices, and evaluate themselves against the needs and demands of the health care system of the future. This system of the future will require significantly more involvement on the part of consumers, and will operate in an environment that demands a relentless focus on reducing costs, improving quality and access to care, and improving the perceived satisfaction of both patients and caregivers. It will require those who deliver care to focus on developing innovative ways of providing this care. An organizational approach to learning and development, with a focus on innovation and creativity will become essential. To meet these goals for health care, we must focus on the professional development of leaders and staff members, their ability to continually reinvent their approach to providing care, and developing their skills to support the attainment of the organization’s goals.

The Transformational Model for Professional Practice in Health Care Organizations was developed as a "framework" for that purpose. It is a descriptive picture of the factors necessary to support professional practice and patient care, the processes necessary to meet the challenges of tomorrow’s health care systems, and the outcomes that can be anticipated.

The Transformational Model is divided into four components. In the Professional Practice Component, assessment and activation of professional practice relationships and support occur. In the Process Component, there is engagement in purposeful and deliberate critical thinking, negotiation, and decision making which brings together (1) the unique needs of each patient, (2) professional recommendations, and (3) effective resource management. This results in attainment of targeted goals, or Primary Outcomes, which enhance quality care, patient satisfaction and caregiver satisfaction; and Strategic Outcomes of consumer, organizational and professional health.

The Transformational Model is applicable to any health care organization or system. The concepts can be "customized" to a specific organization or system based on that organization’s vision, values, goals and intended outcomes. This model can provide the framework for developing a plan for integrating a health care system, balancing competing priorities, developing and maintaining a cultural identity, developing leaders and staff, and maintaining an unerring focus on the organization’s values and goals.

The Transformational Model

The Professional Practice Component

The inner core of the Professional Practice Component contains the heart of the model. This core reflects the unique contribution each clinical discipline brings in caring for a patient. In times of transformation and limited resources, it is critical that each clinical discipline carefully analyze its practice to eliminate elements that do not add demonstrated value to patient outcomes. Those elements remaining must be carefully protected and supported.

This support is provided through the 20 concepts surrounding the core. These concepts are divided into four sections:

Transformational Leadership
Care Delivery Systems
Professional Growth
Collaborative Practice

The Process Component

The Process Component is intended to reflect the processes used by professionals in caring for patients. In a transformed health care environment, "routines" of care that do not add value to patient care need to be abandoned. Care requirements will be negotiated between the patient and caregivers, resulting in highly individualized goals. Once these goals are determined, the mutually established plan of care will be purposeful, reflect the uniqueness of the patient, be sensitive to the availability of resources, and be targeted directly to the desired outcomes.

The Primary Outcome Component

The Primary Outcomes related to the patient include the level of:

• Satisfaction with the quality of care received and accessibility of care.
• Congruence between the patient and caregiver in determining health care needs, and prioritizing health care services and activities.
• Responsiveness to patients’ needs (as perceived by the patient).
• Participation in planning and executing care.

The Primary Outcomes related to the Health Care Team include:

• A dynamic work environment that is supportive of high performance behaviors.
• The transformational quality of professional relationships.
• The voice and power of caregivers to contribute to the goals of the organization.
• The support available for personal and professional growth.

The Strategic Outcome Component

The Strategic Outcomes related to consumers include:

• The willingness of consumers (patients, caregivers, third-party payors, etc.) to promote and or engage in future relationships with the organization

The Strategic Outcomes related to the organization include:

• The increased ability to respond flexibly to the dynamic changes in health care.
• The increased ability to position itself to compete financially in the health care market.
• An enhanced reputation for the provision of quality care.

The Strategic Outcomes related to the profession include:

• The ability of the members of the organization to influence the direction and growth of individual members of the organization, as well as the professional organizations to which they belong.
• The ability of the members of the organization to influence the direction and growth of the professional disciplines (medicine, nursing, pharmacy, social services, etc.) through educational offerings, professional publications, and research contributions.
• The willingness of the organization to invest in the future direction of the professional disciplines.

Implementation of the Model

The concepts within the four sections of the Professional Practice Component will be operationalized differently depending on the organization’s developmental level.

Using an adjunct model developed by Nelson and Burns, organizations can be categorized into four levels: reactive, responsive, proactive, and high performing. At the reactive level, there is often both a crisis mentality, and minimal teamwork. Personnel are focused on "survival," and are often paranoid, pessimistic, and distrustful.

At the responsive level, staff are cohesive and focused on achieving near-term goals. They are able to handle problems appropriately and effectively.

The proactive level builds on the responsive level and expands it. At this level, the future is seen as a choice to be made, not something with which one must cope. Strong shared vision and values serve as a compelling force for actions which prepare for that future.

Continuing to build on the proactive level, the high performing level emerges. There is a high level of synergy, energy, spirit, and creativity that results in a superior level of performance.

The following grids reflect on each of the concepts in the Professional Practice Component at a reactive, responsive, proactive, and high performance level. These grids can be used for an organizational, departmental, or individual assessment. They can also serve as a "road map" to guide organizational development.

Transformational Leadership
Care Delivery Systems
Collaborative Practice
Professional Growth

Applications of the Model

The Transformational Model for Professional Practice can provide the framework for your:

• system/organizational statements of mission, philosophy, and goals
• strategic planning
• operational planning
• outcomes management
• system and organizational management plans
• committee/support structures
• recruitment
• orientation and continuing education
• role descriptions and evaluation tools
• leadership development
• staff development
• research applications

Printable Documents

The information contained on this page is available in Microsoft Word (DOC), Microsoft PowerPoint (PPT) and Adobe Acrobat (PDF) files.

The Transformational Model for Professional Practice in Health Care Organizations Brochure (PPT format)

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