Student Name

Capella University

NURS-FPX4005 Nursing Leadership: Focusing on People, Processes and Organizations

Professor’s name

Submission Date

Interdisciplinary Plan Proposal

The proposal will help solve the problem of longer patient stays due to failure in interdisciplinary communication in the acute care units of Riverbend Medical Centre. Lack of concerted efforts between nurses, physicians, case managers and social workers typically leads to delayed updates, poor responsibilities and discharge bottlenecks. The plan will include interdisciplinary huddles to occur daily and the SBAR communication model to allow for a more effortless flow of information and better discharge preparedness and overall patient flow throughout the hospital.

Objective

The primary aim of this plan is to improve interdisciplinary communication throughout the discharge planning process through integration of daily huddles and standardised Situation, Background, Assessment, Recommendation (SBAR) communication between care teams. Such tools will ensure that the plan will encourage information exchange in time, explaining discharge barriers and coordinating the action among nurses, physicians, case managers, and social workers (Houte, 2024). This goal will minimise unnecessary delays, increase patient satisfaction, and contribute to the overall organisational purpose of improving the efficiency and timeliness of care in the hospital. Better communication will also reinforce decision making, reduce the length of stay in the hospitals and eliminate the flow-of-work disruptions. The plan will help the organisation to offer more coordinated, safer, and patient-centred care by establishing stable and orderly communication channels.

Questions and Predictions

In order to make this plan successful, one has to look into the viability of the plan, potential obstacles, and the results expected. These guiding questions will allow the team to analyse the possibility of including daily huddles and SBAR communication in the discharge processes and define areas that need to be refined. This analysis through reflections will allow for positive changes in collaboration and the positioning of the initiative in line with organisational objectives in the long term. The questions and predictions that will be generated below will help with planning and support the change that will be measurable and meaningful.

Question 1: What is the impact of the introduction of daily interdisciplinary huddles and SBAR on discharge coordination?

Answer 1: It might be necessary to allow the staff time to learn to get used to the structured communication routines in the beginning, but with the development of consistency, the barriers to discharge will be detected earlier, information will be passed on more reliably, and patient throughput will increase.

Question 2: What is the training and preparation required to be able to use SBAR and daily huddles effectively?

Answer 2: Brief training, sample templates and time constraints for practice will be mandatory. Though it could require some time-based investments in the initial stages, the benefits in the longer run will outweigh the initial investment in the form of fewer delays and smoother coordination.

Question 3: In what timeframe will discharge timeliness improvements be seen?

Answer 3: The first improvements can be noticed during the first few weeks, e.g., better updates and fewer misunderstandings. Significant changes in the discharge efficiency will be achieved within two or three months of regular practice.

Question 4:  What difficulties can arise in the implementation process?

Answer 4:  Familiar impediments include a lack of regular attendance, incompatible schedules and dislike for new habits. However, adequate leadership support, responsibility in the huddles and appreciation of progress will contribute towards acceptance and regular use.

Question 5: How will the continuous evaluation promote continuous improvement?

Answer 5:  Weekly review and interdisciplinary check-in of feedback will help in identifying gaps and ensuring positive practices continue to be upheld, as well as providing team members with the motivation to stay on track with each other.

Change Theories and Leadership Strategies

The application of Change Management Theory by Lewin will be used to help the staff in a well-organised and long-term shift to implement this plan. During the unfreezing phase, the leaders will emphasize what exists: delays in discharges, and present data demonstrating the impact of that delay on patient flow and create a sense of urgency to change. The changing stage will include the implementation of daily huddles and SBAR training, its examples and willingness to engage the team. During the refreezing step, the new communication practices will be cemented by regularly evaluating and providing feedback on them and making them part of the regular workflows in the unit (Smoot, 2021). Such a systematic nature will contribute to ensuring that the changes in communication are sustainable, stable and stable.

Team commitment and improvement of collaboration in the implementation will be stimulated with the assistance of transformational leadership. Transformational leaders motivate employees by promoting a shared goal towards improving patient outcomes, setting a good example of practical communication skills, and creating a positive culture of trust and respect (Ystaas et al., 2023). The nurse leader will promote free discussion in the huddles, recognise the team contributions, and promote a sense of ownership in all disciplines. Such a leadership approach will help to reduce resistance, encourage engagement and build trust in the new communication model.

With the assistance of the Lewin Change theory and transformational leadership, the plan creates a realistic and encouraging system of improving the discharge communication. The methodical steps developed by Lewin ensure that the change is implemented in stages and with reasonable support. In contrast, the transformational leadership approach supports the change emotionally, empowers and motivates the employees to stay engaged in the team (Ahmed et al., 2022). Collectively, these strategies promote accountability, interdisciplinary collaboration, and the spirit of commitment to safe, efficient, and patient-centred care by the organisation.

Team Collaboration Strategy

The successful implementation of the plan will be achieved with the aid of well-defined responsibilities, high-order communication, and mutual responsibility of people within the team of different disciplines. Nurses will determine the readiness to discharge, write SBAR reports at the end of every shift and provide appropriate information at daily huddles. In the electronic health record, medical choices will be explained by physicians, while outstanding problems will be unresolved and anticipated discharge schedules will be recorded (Park, 2022). Case managers will assess post-acute care needs, coordinate services and liaise with other partners. The social workers will also be aware of social or financial impediments that affect transitions and liaise with case managers to eradicate them. The process will be monitored by the nurse leader, who will lead weekly interdisciplinary reviews and is a problem solver for new challenges.

The timely communication and efficient coordination will be supported with the collaborative approaches, including the daily interdisciplinary huddles and shared EHR tools. The huddles will be a short but intensive format of discussing discharge barriers in real-time, which will enable the team members to streamline their priorities and work together in resolving the problems (Park, 2022). Similarities in the use of EHR will facilitate uniformity of updates, access to correct information by all disciplines, and less duplication of work or lack of clear communication. The strategies will enable openness, reduce fragmentation, and make it easier for workflow in care settings.

The fostering of freedom of communication in the team will result in the development of psychological safety and move to proactive consideration of problems. Once their members feel that they are respected and listened to, they will be more open to share their concerns, offer insights and participate in any joint decision-making (Jasubhai, 2025). With the improved communication between the teams of disciplines, there will be reduced time delays in discharge, communication between changing patients will become more efficient, and the labour efficiency will increase. The culture of collective responsibility and respect will continue to support the unity of the team and strengthen the aspirations of the hospital to enhance patient-centred outcomes.

Required Organisational Resources

The successful implementation of this plan will include the allocation of specific resources (training, staff time, communication tools, etc.). A two-hour SBAR and huddle-training session will be implemented with every member of the team, and the overall cost per interdisciplinary group is estimated to be about 2000 dollars. Approximately three hours a week will be used for the oversight, progress monitoring, and follow-up meetings by the nurse leader (Park, 2022). Taking updates, contributing to communication and documenting them will be carried out by using the available EHR systems without the necessity to make further technological acquisitions. Low costs will involve small costs, such as printed SBAR templates and educational resources, that will be estimated to cost 200. Such resources will provide a good baseline of uniformity of communication and greater discharge coordination.

Unless this plan is adopted, Riverbend Medical Centre will continue to have inefficient discharge procedures that have contributed to the lengthy hospitalisation, low patient satisfaction, and cost burden. Patient throughput delays can lead to overcrowding, stress on the staff and reduced ability to receive new patients. These inefficiencies may result in more operational costs, burnout of the people working, and potential patient safety risks in the long term (Sartini et al., 2022). An investment in organised communication practices will thus prove cost-effective and will be key in advancing efficiency, safety, and sustainable interdisciplinary co-operation.

Conclusion

The interdisciplinary plan proposal aims at improving the process of coordination of discharges in Riverbend Medical Centre by the use of daily huddles and SBAR communication tools. The plan is grounded on the Change Theory of Lewin and the principles of transformational leadership practices, which contribute to the process of planned change, collaboration and enhancement of long-term. This initiative is predicted to be effective in improving the efficiency of discharging and patient satisfaction since it will result in consistent communication, shared accountability, and mutual respect among nurses, physicians, case managers, and social workers. This can be done through effective use of resources, continued feedback, and continued leadership support, which will ensure successful implementation and long-term impact. Finally, this plan helps the organisation to achieve its goals of providing safe, effective and patient-focused care by means of effective interdisciplinary collaboration.

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