Door-to-Balloon Time Reduction: Negotiations

The paper indicates reasons for each stakeholder in supporting the proposed plan for improving the door-to-balloon time in the STEMI patients at Kendall Regional Medical Center.

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STEMI patients and families

Reasons for Supporting

  • Promise for improved care outcomes
  • Promise for timely interventions

Reasons for Not Supporting

  • Failure to understand the issues involved in providing consent
  • Failure to involve them in designing and implementing the change effort
  • Inability to understand the symptoms of STEMI, leading to delay in seeking treatment

Negotiation Strategies

Engaging in honest communication with patients and family members to explain the importance of consenting and to request for their involvement (Aarons et al., 2014)

Emergency department physician

Reasons for Supporting

  • Ability to apply evidence
  • Having a positive attitude toward the EBP intervention
  • Adequate training in the STEMI area
  • Management support

Reasons for Not Supporting

  • Noninvolvement in designing and implementing the change effort (Majid et al., 2011)
  • Desire to maintain the status quo

Negotiation Strategies

Collaboration and sharing important information with the physician so that he or she may see the benefits of the change effort (Irwin, Bergman, & Richards, 2013)

Paramedics/Emergency response team

Reasons for Supporting

  • Ability to apply evidence
  • Adequate training in the STEMI area
  • Management support

Reasons for Not Supporting

  • Inability to prioritize due to the heavy workload
  • Lack of time
  • Attitudinal problems
  • Lack of institutional support
  • Noninvolvement in the change effort

Negotiation Strategies

  • The rank-ordering strategy can be used to ensure the paramedics understand what is needed and can use the limited time to support the practice change.
  • Collaboration and sharing of information can be used to address attitudinal and noninvolvement issues (Duiveman, 2012)

STEMI team

Reasons for Supporting

  • Ability to apply evidence
  • Adequate training in the STEMI area
  • “Availability of protected time to learn and implement EBP” (Majid et al., 2011, p. 234)
  • Management support

Reasons for Not Supporting

  • Difficulties in understanding the statistical analyses for various STEMI tests (Pan et al., 2014)
  • Role ambiguity
  • Lack of resources
  • Lack of knowledge about EBP (Majid et al., 2011)

Negotiation Strategies

The strategy is to gain access to the team leader to convince him or her to mentor members of the STEMI team using the EBP advocate framework (Irwin et al.,)

PBX operator

Reasons for Supporting

  • Support by other players
  • Adequate training on what needs to be done to contact and prepare stakeholders so that ball to balloon (D2B) time is significantly reduced

Reasons for Not Supporting

  • Lack of skills and knowledge on the change effort
  • Noninvolvement in the change effort

Negotiation Strategies

Honest communication can be used to address the issues

Invasive cardiologist

Reasons for Supporting

  • Ability to apply evidence
  • Adequate training and time to learn and implement the change effort
  • Management support

Reasons for Not Supporting

  • Insufficient evidence that the practice change will improve patient outcomes
  • Desire to maintain the status quo
  • Insufficient time
  • Noninvolvement of the change effort
  • Lack of institutional support

Negotiation Strategies

  • Collaboration and compromise strategies can be used to bring the invasive cardiologist to the negotiating table and ensure that an agreement or settlement is reached on issues that may be influencing their decision not to support the change project (Irwin et al., 2013).
  • The accommodation strategy can be used to yield into some of the demands of the cardiologist so that the project can be implemented successfully (Melnyk & Fine-Overholt, 2015)

References

Aarons, G.A., Fettes, D., Hurlburt, M., Palinkas, L., Genderson, L., Willging, C., & Chaffin, M. (2014). Collaboration, negotiation, and coalescence for interagency-collaborative teams to scale-up evidence-based practice. Journal of Clinical Child & Adolescent Psychology, 43, 915-928. DOI: 10.1080/15374416.2013.876642

Duiveman, T. (2012). Negotiating: Experiences of community nurses when contracting with clients. Contemporary Nurse: A Journal of the Australian Nursing Profession, 41(1), 120-125.

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Irwin, M.M., Bergman, R.M., & Richards, R. (2013). The experience of implementing evidence-based practice change: A qualitative analysis. Clinical Journal of Oncology Nursing, 17, 544-549. DOI: 10.1188/13.CJON.544-549

Majid, S., Foo, S., Luyt, B., Zhang, X., Theng, Y.L., Chang, Y.K., & Mokhtar, I.A. (2011). Adopting evidence-based practice in clinical decision making: Nurses’ perceptions, knowledge, and barriers. Journal of the Medical Association, 99, 229-236. DOI: 10.3163/1536-5050.99.3.010

Melnyk, B.M., & Fine-Overholt, E. (2015). Evidence-based practice in nursing & healthcare: A guide to best practice (3rd ed.). Baltimore, MD: Lippincott Williams & Wilkins.

Pan, M.W., Chen, S.Y., Chen, C.C., Chen, W.J., Chang, C.J., Lin, C.P.,…Chen, Y.C. (2014). Implementation of multiple strategies for improved door-to-ballon time in patients with ST-segment elevation myocardial infarction. Heart Vessels, 29, 142-148. DOI: 10.1007/500380-013-0336-2.

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StudyCorgi. (2020, November 16). Door-to-Balloon Time Reduction: Negotiations. Retrieved from https://studycorgi.com/door-to-balloon-time-reduction-negotiations/

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"Door-to-Balloon Time Reduction: Negotiations." StudyCorgi, 16 Nov. 2020, studycorgi.com/door-to-balloon-time-reduction-negotiations/.

1. StudyCorgi. "Door-to-Balloon Time Reduction: Negotiations." November 16, 2020. https://studycorgi.com/door-to-balloon-time-reduction-negotiations/.


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StudyCorgi. "Door-to-Balloon Time Reduction: Negotiations." November 16, 2020. https://studycorgi.com/door-to-balloon-time-reduction-negotiations/.

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StudyCorgi. 2020. "Door-to-Balloon Time Reduction: Negotiations." November 16, 2020. https://studycorgi.com/door-to-balloon-time-reduction-negotiations/.

References

StudyCorgi. (2020) 'Door-to-Balloon Time Reduction: Negotiations'. 16 November.

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