Question 1 Using the ‘R’ ‘Relevance’ in facilitating Tobacco

Question1: Using the ‘R’ ‘Relevance’ in facilitating Tobacco usecessation among patients

Duringmy pre-licensure attachment at the department of health in Detroit, Iwas involved in change management for tobacco addicted patients. Thepatient had been admitted at the County hospital with adverse chestcomplications arising from an extended period of Tobacco smoking. Iwas attached to the recovery and rehabilitation department and I wastasked with the responsibility of making decisions and facilitatingpatients’ recovery. As such, I was required to facilitate inenhancing the patient recover from excessive tobacco usage. Toachieve this, I applied the principle of ‘Relevance’ in assistingthe patient quit tobacco. ‘Relevance’ in this case was applied toencourage the patient on why quitting was relevant. The following isthe change management plan adopted to enhance ‘Relevance’ ontobacco smoking by the patients.

Step1 ASK

Inthis case, I gathered data from the patients on how often he usedtobacco. The goal was to assess the extent of addiction and helparrange the best withdrawal plan. The step was also important indetermining the variables that predisposed patients to tobaccoaddition. This would help in my intervention plan.


Theobjective of this step was to show relevance to the patients on whyquitting was important. This was achieved by advising the patient toengage in active activities that distract them from smoking. I alsoadvised the patient to reduce the amount of cigarette smoked per day.


Regularmeeting were arranged with the patient on regular basis to assess theprogress. In particular, the regular sessions were aimed atencouraging the patients see the need to quit smoking. The regularmeetings helped in assessing patients’ willingness to continue withtreatment for full abstinence from smoking.


Assistancewas provided to the patients even when they showed less willingnessto quit smoking. This involved minimal interventions, arranging forcounseling sessions and group therapy to help patients quit smoking.Multiple counseling sessions were arranged for patients to enhanceprolonged abstinence. In some cases, counseling sessions werecombined with smoking cessation medication.


Regularfollow-ups were conducted on patients to assess response, modifytreatment and provide support. In most cases, the NicotineReplacement Therapy (NRT) was applied to encourage patients recover.

Wasthis change a comfortable or uncomfortable time in your life?

Theintervention change was uncomfortable during the initial stages. Itwas hard convincing the addicts on how to make quitting decisions.Most patients would cooperate during the first sessions but wouldshow recurrence addiction during the follow-up sessions. It was quietdisappointing but with the support of the counseling, group therapyand nicotine treatment, the process becomes easy.

Nonetheless,I learned an important experience in change management in healthcarepractice. In particular, I learned that healthcare providers needhigher degree of patient, understanding, persistence and negotiationskills. Furthermore, I learned that change management in health care,is a collaborative responsibility. All important stakeholders need tocooperate in decision making and change implementation (Finkleman,2012).

QuestionTwo: Making Important Decisions when Managing Patient-Centered Care

Patient-centeredcare is a new approach care that is focused on individual patientsneeds. Patient-centered care is care that is responsive, respectfulto individual patient needs, values and preferences. Patient’sneeds, values and preferences form the basis of physicians’clinical decisions. As such, healthcare specialists need reliableleadership characteristics that make important decisions for positivechange on patients’ health (Finkelman, 2012).

Qualityleadership characteristics that lead to positive change inpatient-centered care involve employing measurable skills andbehaviors. Physicians as leaders in healthcare system should involvepatients through consultation when making healthcare decisions.Physicians should show care, empathy and concern for their patients.Patients’ needs and values should guide physicians when makingdecisions. This is only possible if physicians can establish mutualrelationships with clients (Finkelman, 2012). In this case, effectivecommunication, empathy and developing partnership between doctors andpatients lead to improved care outcome, satisfaction and quickrecovery of patients. At the core of effective patient-centered careis effective leadership.

Healthcareleaders should be sufficiently committed and engaged to sustain thehealthcare by enhancing effective physician-patient relationships.Healthcare leaders need to have a strategic vision that is clear andconstantly communicated to all members in the organization. Effectiveleadership in patient-centered care should facilitate the involvementof patients and families when making important decisions.

Physiciansand other caregivers should have a supportive work environment fromthe healthcare leadership for full engagement in the process ofdesign and treatment. Healthcare leaders need to employ systematicmeasurements and feedback for assessing the impact of specific changepractices and interventions. Decision making in patient centered careis a shared responsibility. Patients have the greatest say whenmaking healthcare decisions.

Thefirst step in decision making for patient centered care is respectingthe needs, preference and values of patients. The next step involvesinformation sharing where healthcare practitioners share andcommunicate unbiased and complete information to patients. Thisaspect of information sharing helps the patients participateeffectively in decision making. In the third step, patients andfamily members are encouraged to participate in decision making toassess the best health care approach.

Thelast step involves collaboration patients and healthcare providerscollaborate in the implementation of healthcare. The underlyingaspect is patients’ inclusiveness throughout the healthcareprovision process. In this process shared decision making occurs whenhealthcare leaders and patient (relatives and homecare givers) worktogether in making the best healthcare decision for patients(Finkelman, 2012).

MyLeadership SMART Goal for Patient-Centered healthcare provision

Theplan in this case involves designing a health care response to anelderly patient suffering from diabetes. The goal is to makeeffective healthcare approach for the patient. The patient, patient’srelatives, homecare givers, physician and nurses will be involved.The objective is to have a consensus on the effective way thepatient’s health will be monitored (Finkelman, 2012). Decisionmaking will be done in the clinic where the patient is receivingtreatment or at home depending on patient’s condition.

Howthe goal will be achieved

Thefirst thing will be welcoming the patients’ family and friend indecision making. This will be achieved by elaborating the patient’shealth condition and the needed care for easier recovery. In thiscase, at least three members who are close to the patient will beinvited and given details on the patient’s health requirements.Special emphasis will be attached to human value than technology. Thepatient and the healthcare givers will discuss timeframe for actionthat involves series of treatment implementation and monitoring(Finkelman, 2012).

Patient’sfeedback will form an important aspect in guiding healthcareproviders. Several meetings will be arranged between healthcaregivers and the patient’s family members with the goal of fosteringa connection and responsive treatment to patients. Supportivetechnology will be used to enhance communication between caregiversand patients. Information sharing will be given the first priorityamong the caregivers. This will allow for effective feedback andmonitoring.

Attainable:Resources available to assist in my goal

Physicians,nurses and home care givers will be important resources in providingthe patient with effective care treatment. Supportive technology suchas emails and Skype will be used to facilitate communication.


Thegoal of this patient centered healthcare is to enhance acollaborative physician-patient interaction in the provision of homeor hospital based care. Empirical studies affirm that, patientsrecover fast when a collaborative spirit exists between healthcareproviders and patients (Finkelman, 2012). It is presumed that thiscollaboration in healthcare provision for the diabetic patient wouldlead to quick recovery within a period of six months. The success ofthe patient’s treatment would be made possible through regular openmeetings where physicians, nurses and patients engage in honestconversation about the services offered.

Importanceof strategic planning in health care

Strategicmanagement is effective in patient-centered healthcare provision. Itis through strategic planning that effective improvement on patient’shealth can be achieved (Finkelman, 2012). Strategic planning inhealthcare facilitates effective management of patient’s data foroverall improvement on health care. Strategic planning is a usefultool that helps in controlling the present and the patient’s futurehealth. Strategic planning gives the healthcare practice the neededstructure that is important in making day-day decisions on patient’shealth (Finkelman, 2012).

Inaddition, strategic plans help in achieving the goal set. Forinstance, a strategic plan is useful in patient-centered care whereall aspects of patient treatment are discussed. Strategic planensures that the present and the future health status of the patientare well catered for. Furthermore, strategic plans help in managingmonitoring feedbacks and making adjustments where necessary(Finkelman, 2012)


Finkelman,A. (2012). Leadershipand management for nurses: Core competencies for quality care (2ndEd.) Upper Saddle River, New Jersey: Pearson.&nbsp