Current health problems of the society require a broad range of solutions that may enhance the health care sector. These solutions should include various aspects including assessment, research, scientific development, treatment, drugs and equipment research and design as well as others. Such measures are the major demand of the society because there are diseases that require researches and treatment. The vast majority of such diseases are non-communicable (NCDs). Despite being known for several decades, they still endanger the community by high death rates, complications and the worsening of the quality of living. The statistics of NCDs is thrilling. Thus, every day more than 100,000 people die of NCDs worldwide; scholars predict that by 2030 more than seven out of 10 people would die from an NCD (Fraser 2011). Unfortunately, the similar statistics of the mortality caused by the cardiac diseases can be explored in Canada.
Consequently, cardiac diseases remain in the top of the list because of their immense contribution to this list. For instance, in 2008, cardiovascular disease accounted for 29% of deaths in Canada with 54% of them due to ischemic heart disease (Heart and Stroke Foundation of Canada n.d.). That is why there is a social need for medical facilities and units that deal with the whole specter of heart diseases. Such units would enhance the disease management in their vicinity on the basis of up to date methods of research and treatment. Therefore, the paper argues with the perspective of the introduction of the heart disease management unit (HDMU) in any local hospital of Canada. Moreover, it discusses the need for such unit, describes the role of the head of the unit and various organizational issues. One presumes that the proposed unit in the described structure would be efficiently performing its tasks.
The introduction of a new medical unit into a hospital requires reasoning and assessment of its need and functions. That is why, one needs to examine the most important issues of the community in terms of health care. The introduction of the HDMU in its turn requires the designing manager to be sure that the threat of heart diseases is reasonable.
First, as it was mentioned earlier, heart diseases seriously contribute to the number of reasons of death in the country. For instance, more than 1.4 million Canadians have cardiovascular disease (CVD). Moreover, it is one of the principal causes of mortality in Canada with about 33,600 cases per year (Heart Disease – Heart Health n. d.). Furthermore, according to the Public Health Agency of Canada, 1.6 million Canadians are living with the effects of a stroke (Decline in Deaths from Coronary Heart Disease and Stroke n. d.). Manuel et al. (2003) claim that despite CVD is the leading cause of death in Canada, these rates have a tendency to decrease. Thus, they indicate that “between 1950 and 1999 the death rates from CVD dropped from 702 per 100,000 to 288 per 100,000 men, and from 562 per 100,000 to 175 per 100,000 women” (Manuel et al. 2003). However, the recent studies indicate that CVD could increase because of the enlarged incidence of obesity and diabetes, which are two risk factors for CVD (Decline in Deaths from Coronary Heart Disease and Stroke n. d.). Thus, according to the statistics, “26.0% of Canadians currently smoke, 14.9% are obese, 53.5% are physically inactive, 11.3% have low income, 13.0% have hypertension and 4.2% have diabetes” (Tanuseputro et al. 2003). Moreover, the study by Tanuseputro et al. (2003) argues that CVD contributed to 23% of the causes of mortality.}}
Furthermore, on the basis of annual researches, scholars define the prognoses on the health of the nation. Some of them are far from optimistic because of the overall negative tendencies towards unhealthy way of life. For instance, stroke is a major cause of mortality and disability in Canada resulting in $3.6 billion expenditures due to premature death and long-term disability (Tracking Heart Disease and Stroke in Canada - Stroke Highlights 2011 n.d.). Assuming the predictions, the country’s expenditures on the health care because of direct and indirect medical costs of CVD would dramatically rise. Therefore, heart diseases do not only cause mortality of the citizens but raise the overall expenditures of the country on the health sector. Thus, one presumes that cardiac diseases are the burden of the nation which needs a substantial national response.
Therefore, the Public Health Agency of Canada attempts to combat the mentioned issues through the introduction of various initiatives. One of them is Canada’s Cardiovascular Disease Program. It is focused on cardiovascular disease surveillance, prevention and the development of educational resources and community initiatives for health professionals and the general public (Healthy Living and Chronic Disease (HLCD) n. d.). It encourages the collaboration of non-governmental and educational institutions, medical practitioners as well as territorial governments. Furthermore, the Government of Canada developed the Canadian Heart Health Strategy and Action Plan (CHHS-AP) which was released in February 2009 (http://www.phac-aspc.gc.ca/cd-mc/cvd-mcv/funded-projects-subventionnes-eng.php). The introduction of the plan aims at combating the full range of the factors that contribute to the mortality caused by CVD. Moreover, it identified negative health factors as well as introduced the criteria that classify people that achieve bad, intermediate or perfect levels of health. Thus, the communities should support the CHHS-AP to combat the described issues that endanger the citizens.
The goals set by the CHHS-AP could be achieved through the design of new medical facilities or units aimed at CVD prevention and treatment. As practice shows, the organizations that have relevant goals and methods of action are successful and assist the community. One might explore the examples of such activity in the other countries. For instance, Ford and Capewell (2011) argue with the experience of the North Karelia project launched in Finland in 1972 to combat high cardiac diseases ratio. The study of this project assessed the community and revealed the three major factors contributing to the negative statistics. They were smoking, total cholesterol and blood pressure. Consequently, the community analyzed the theoretical framework and developed the program reflecting the needs of stakeholders. Consequently, the impact of the designed organizations was impressive. From 1972 to 1977, the proportions of men who smoked decreased from 52% to 44%, and the mean concentration of total cholesterol dropped. As a result, the mortality rate caused by cardiac diseases among males in North Karelia decreased by 2.9% per year between 1969 and 1978 (Ford & Capewell, 2011). Further statistics show gradual annual acceleration of this process which approves the efficiency of the proposed model. At the same time, the community should include the experience of the countries worldwide. For instance, Ford & Capewell (2011) indicate that some of the similar programs in the US addressing CVD were not efficient. Despite their address towards the similar issues, their implementation was poor which indicated the need for the improvement. Thus, the design of the proposed CVD combating initiatives should evaluate the risks and factors that restrict the successful implementation of the CHHS-AP. Furthermore, one proposes that all goals set by the CHHS-AP can be achieved through the design of the HDMUs in the hospitals throughout the country.
The mission statement of the HDMU is the monitoring of the statistics of the cardiac diseases in the vicinity and their further management. Cardiac diseases prevention and treatment are the subjects of their primary attention. Thus, the basic value of HDMU should be the quality of life of the citizens through the successful CVD management. Staff is obliged to assist the local community in gathering up to date information about the risks of the CVD and their prevention, and treatment. One of the revolutionary aspects is the assessment of these risks regarding the local environment and way of living. Thus, the tasks of each HDMU reflect the CVD issues that arise from the specific area. Consequently, the character of the response to the local challenges of the disease impact the organizational design of the unit.
The design of any organization should provide its efficiency. From the one hand, it should have enough staff for performing daily operations. The unit should not be either overcrowded with personnel or miss any members of staff. From the other hand, its organizational chart is crucial in terms of the assurance of the adequate response to the social and medical challenges. Figure 1 shows the organizational chart of the unit within the hospital structure. The unit subsides into two departments. The research department is responsible for the statistics, research and informing of the population in the area. Its primary aims are control and prevention of CVD through the operations with information. The treatment department is responsible for practical nursing interventions. One half of it admits patients in a hospital whereas another one assists the emergency in case of CVD related calls.
The director of HDMU is the leading position of the unit. His or her primary aim is enhancing the practice of the unit through the implementation of the leadership practice. Moreover, one’s task at this position is managing staff as well as the organizational issues. This position requires the leading qualities relevant for a nurse. The AONE Nurse Executive names such of them as communication and relationship-building, knowledge of the health care environment, leadership and professionalism (AONE, 2011) (Figure 2). Thus, a nursing leader has to make presentations, contact with staff and stakeholders developing the relationship and resolving conflicts. Furthermore, he or she has to build trust and develop the diverse community confronting and managing the possible inappropriate behavior of staff and patients. One has also to be aware of clinical practice and the state laws assuring the application of the relevant evidence practice methods. Human resource, financial and strategic management are also of crucial importance. To develop these qualities, one needs to obtain proper nursing leadership education and have the experience in leading some of the nursing units. The rest is a constant work to develop the obtained qualities through the obtaining of the experience. Additionally, to foster the development of the leading qualities, one should go through the leadership courses to approve one’s reliability and validity as a nursing leader.
However, a leader is only the minor part of the unit because the rest of staff does the major practical work. Thus, they require proper motivation and will for work which a leader often achieves through the empowerment of staff.
A successful and efficient leader always has a broad range of strategies used for the empowerment of staff. The reason for such measure is that a properly empowered team aspires for cooperation and achievement of the daily goals. Furthermore, it has enough motivation to actualize its creativity in the daily work and implement its full potential performing the tasks and duties. One may propose five successful strategies that are useful in the empowerment of staff members.
The first strategy is the share of information. It is important because every member of staff should be equally informed about the latest events in the unit as well as the latest explorations. This gives staff the feeling of the belongingness to a single group where people share all concerns. This strategy follows with the shared decision making. If each member of the unit participates in decision-making, that adds to the feeling that his or her opinion is important to staff and a leader. Such equality in knowledge and decision making fosters staff to unite as if a single functioning organism. However, this requires enough skill from a leader to assure that everyone’s opinion has an adequate reception by a group.
The third strategy is the development of the common vision and common goals. Common goals are the factors that unite people in a short and long time perspective. While sharing a common goal, staff incorporates its efforts and creativity to overcome the daily problems and challenges to reach the required aim. One of the examples where a leader may attempt to unite staff through the common goal is planning. One may propose to participate in the planning process for everyone to contribute his or her own goal. Thus, in case the plan implements the opinions and visions of the others, it has a great importance to every individual of the group.
The next strategy is fostering employees towards the professional development. The reason for it is that the professional growth is extremely important in any work. Gradually, the daily challenges of employees may become more complex which require staff to raise its level of education and practice. In such cases, a leader may use coaching and sharing experience as a tool for the empowerment. In this case, the individual approach to the development of the professional qualities of any member of the unit would enhance personal relationship and trust.
The last strategy that might be used to enhance the empowerment of personnel is understanding of the needs of its members. It is not a secret that all of us are individuals with personal needs and wishes. Their understanding by a leader might open the best way of the empowerment because personal issues are the most valuable for any person. Being aware of the potential and flaws of every worker, a leader has a possibility to maximize one’s potential and overcome the possible problems.
The mentioned strategies provide a leader with a powerful toolkit capable of boosting the productivity of staff. Moreover, it fosters the development of the trustworthy relationship of personnel with each other and a leader. Thus, trust, shared information, critical thinking and similar goals as well as vision are extremely efficient strategies empowering staff to cope with the daily duties achieving the common goals. Any prospective and skillful leader understands their role in the unit and would practice them enhancing the practical efficacy of the unit.
In order to explain the functional value and credibility of the HDMU one may give the example of one team working within the unit. This would give the general impression about the work of staff and allow assessing its reasonability. The unit consists of the two departments that are the research department and the treatment department. One assumes that presenting the information about the first one would explain the basic principles of the function of the whole unit.
The research department of the HDMU performs the functions of research and informing. It should provide the statistic and practical researches of patients regarding the issue of CVD. Furthermore, it informs the treatment department of the possibly evolved pathologies, diseases and drugs as well as the equipment and the methods of treatment. Consequently, one of its persistent functions is raising the scientific awareness of the unit and providing the professional development. Additionally, it informs the community of the negative factors affecting the CVD development as well as the methods of its prevention. Thus, the department is split into two groups. One of them works with practical researches and staff whereas another one works with the statistical research and community. Such combination allows the unit performing its functions of research, informing and education raising the competence of the unit.
Any leader requires reflections of the work of his or her team to assess its success and reveal possible problems. Thus, a leader assures and checks the efficiency of the described team through various data obtained though the reports. A leader obtains the reports through different sources. One of them is the team itself; they present individual and quarterly reports. Another source is the colleagues that fill the questionnaires regarding the quality of the information presented to them. Finally, the third source is the community and patients. Each member of the community has a right to give a direct feedback to a leader of the unit if he or she has negative claims. One sees it as the most democratic and objective way of the assessment. This system of assessment gives a comprehensive vision of the work of the selected team and assures its competence.
It is significant to note that one cannot be sure about the overall smoothness and efficiency of the working process in the unit. Thus, a leader should handle critical issues management. They may bear different character ranging from interpersonal to financial. One of the suggested cases for management is when on the first day of the work of the unit one sees two nurses having a heated debate. The reason of their argument might possibly be the principles of the order of the supplies for the unit. Nevertheless, one should know that all organizational issues should have been noted and planned. Thus, there cannot be personal resolution of the conflict since this question should have been solved on the stage of planning. Consequently, all the regulations and orders should have been planned and noted in the appropriate section of the plan. Therefore, if any nurse has doubts regarding supplies, he or she should consider the regulations approved by the direction board of a hospital.
Moreover, another side of this issue is the emotional state of the personnel. After the consideration of regulations, one should suggest nurses to discuss the need for the appropriate behavior in a hospital. The unit treats people with CVD, thus, there are restrictions for nurses from provoking and support of the situations that endanger the emotional state of patients. Consequently, nurses would be instructed not to repeat their arguments and solve the conflict in a more constructive way. In any argument, they should consult their supervisor or the head of the department for the solution. Any cases of misconduct should be analyzed by the directional board with the appropriate decisions according to the degree of threat towards patients and staff.
Summarizing the presented information, one comes to the conclusion that the proposed unit would be efficiently coping with its tasks. As sees from the information, the nation suffers from the heart diseases that contribute to the annual reports of mortality. Thus, the introduction of the HDMU throughout hospitals of the country would help to overcome this problem. Moreover, the proposed structure and methods of regulation ensure the efficiency of the work of its staff. Additionally, the described principles of management would empower the nursing practitioners towards raising their competence. Directed towards the prevention, detection and treatment of the wide range of heart diseases, the unit would elevate the quality of life of the local communities. Therefore, the spread of such units throughout the country would enhance the management of heart diseases and heal the nation.