Effective Workplace Culture Framework for NICU Care Analysis Report

This report critically analyzes the quality of care within a Neonatal Intensive Care Unit (NICU) using the Effective Workplace Culture Framework. The author, drawing from personal experience in an Indian NICU, identifies challenges such as inadequate staffing, lack of role clarity, and insufficient communication with families. The report examines the impact of these issues on compassionate care and patient outcomes. It evaluates the existing workplace culture, highlighting both enabling factors (transformational leadership, skilled facilitation, role clarity) and essential attributes (patient-centeredness, open communication, teamwork). The analysis uses the framework to identify areas for improvement and synthesizes recommendations for enhancing the caring culture. These recommendations include implementing patient-centered care, fostering open communication, improving teamwork, and promoting leadership development. The report concludes by emphasizing the importance of these changes in achieving positive patient outcomes and a more supportive work environment.

Running head: NURSING
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Name of the Student:
Name of the University:
Author Note:

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Introduction:
Neonatal intensive care unit involves the provision of critical to new born infants. The
birth of a baby is characterized by a set of complex physiological and psychological changes
both in the mother and the baby. Post birth, it is essential for the baby to adapt to the
environment and make essential physical adjustments so as to adapt to the environment
outside the mother’s womb. Once the baby is delivered from the mother’s uterus, the baby
cannot rely upon the mother’s circulation and placenta for survival and other physiological
functions. In this regard, it should be mentioned that the babies that are born with critical
physical health condition and require specialized medical attention are placed under the
Neonatal Intensive Care unit (NICU) for optimal care. The NICU comprises of a set of
skilled professionals who deliver care to the new born with advanced technology and
evidence based practices. It should be noted in this context that the NICU does not only
impart care to the babies who are born with critical illness but also deliver care to babies that
are not affected by critical illness but need specialized care services (Davidson, 2013). I have
worked in a Neonatal Care Unit in India and my professional experience has been an
incredible one. However, the healthcare setting where I was working had certain policies that
hindered with the smooth functioning of the care process. This paper would critically analyse
the problems that hindered a smooth care delivery and compare the quality of the care
process with the effective workplace framework and present suitable recommendations which
could help in improving the quality of service delivery.
Analysis of current compassionate care
The Effective Workplace Culture Framework is the strategy that helps to determine that the
workplace environment that has been developed in the facilities are able to implement patient
centred, family centered and clinically effective care so that people could be provided with

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improved and effective care for their growth and development (Manley et al., 2016). This
effective framework is inclusive of specific aspects that represents individual as well as
organisational aspects and then with providing specific importance to the essential attributes,
it provided details of the positive and negative consequences that could arise due to the
presence or absence of these attributes and aspects (Manley et al., 2016).
Enabling factors
Individual:
As per Manley et al. (2011), the provided framework developed by researcher, helps
the organisation and its employees to assess their workplace cultures and with that provides
the employees to skills to understand the areas that require clarity as well as the skill set that
they would be requiring for their transformation in the healthcare facility, to conduct their
improved and enhanced job role effectively. Hence, the application of this framework in the
healthcare facilities would help the organisational leaders as well as the employees to
understand their shortcomings and they would be able to overcome organisational concerns
(Manley et al., 2011).
Transformational Leadership:
As per Eskola et al. (2016), transformational leadership can be defined as the style of
leadership that is based on the principle of inducing motivation among the workforce so as to
facilitate easier implementation of organization change within a healthcare setting. While
critically reflecting upon my clinical experience it can be said that there is a need to adapt a
transformational leadership style in order to effectively manage the work process and
motivate the employees to acquire excellent service quality. There is a strong need to include
an efficient clinical leader within the organization who would positively influence the
multidisciplinary team of care professionals to practice actively in collaboration so as to

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achieve positive patient outcome and acquire improved job role satisfaction. Research studies
reveal that the implementation of transformational leadership within a health care setting
improves patient outcome and also helps in optimizing employee attrition and burnout
(Fallatah & Laschinger, 2016).
Skilled facilitation: Another important area that should be prioritized by organizations
includes integrating the organization vision among the employees so as to ensure professional
expertise and high quality service delivery. Healthcare organizations must possess a unique
evaluation system that could help in detecting areas where care professionals lack skills and
expertise to render effective patient care. As per Manley et al. (2016), refreshment training
courses and educational workshops can help in developing the professional skills of the
workers. As has previously been discussed the care professionals within the NICU lacked
effective communication skills to communicate with the family members of the patient about
the patient’s treatment progress. This led to anxiety and emotional distress among the family
members of the patient. Conducting effective communication training workshops can help in
improving the professional skills of the care professionals to interact with the family
members of the patient. .
Role Clarification: The primary problem that led to poor service outcome was lack of
adequate staffing and clarity of professional roles to the team of care professionals working in
the healthcare organization. Only five nurses were working within the unit and multiple
activities including, patient documentation, assessment, managing medication and billing had
to be looked after by all the five nurses. As stated by Roue et al. (2017), professional role
clarity within the nursing profession has been studied to speed up the organizational process
and at the same time promote improved performance outcome.
Organizational:

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Flexible and Transparent Management: In order to drive an organizational change in terms of
patient attendance or improving staffing, it is important for the organizational management to
adapt flexibility and transparency within the work process. Both the components of flexibility
and transparency would govern the employees to directly communicate with the management
about the challenges encountered and this would facilitate easier implementation and
resolution of organizational issues. Research studies suggest that hierarchal system of
management often leads to delayed problem solving and conflict management within an
organization (Wang et al., 2014; Real et al., 2014).
Human Resource Management: The human resource management within any organization
serves as a bridge between the employees and the management. The current issues in terms of
lack of appropriate staffing and training in terms of effective communication must be
conveyed to the Human Resource Department along with proposed recommendations so that
the issue could be discussed with the higher management for work process improvement.
This effective framework is inclusive of specific aspects that reflect individual values as well
as the organisational vision and also provides specific importance to the essential attributes
that help in assessing the positive and negative consequences which could arise due to the
presence or absence of essential organizational attributes (Manley et al., 2011). Therefore, the
individual enabling factors that include presence of skilled facilities, transformational
leadership as well as role clarification, and organisational enabling factors such as
organisational readiness and integration of transparent and flexible management, helps to
maintain the effective workplace culture within the healthcare facilities (Manley et al., 2016).
Organisational:
Besides these, the framework also discusses about the presence of important attributes such
as person centred care, leadership and developmental abilities as well as presence of effective

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communication, teamwork and safety elements that helps the organisation maintain effective
work process for the provision of quality care to the patients with the inclusion of family
members in the care process. Further, the positive consequences of these aspects guide the
employees to understand their loopholes and hence empower them to overcome their
shortcomings for the patient’s benefit. Several research papers have also indicated the fact
that application of this framework could provide the employees and the organisations with
the ability to overcome their actions and practices that could improve the quality of their
service delivery (Davidson, 2013; Delaney, 2018; Al-Sawai, 2013). As per Wang and Rafiq
(2014), application of this Effective Workplace Culture Framework is an important factor
that has been reported to improve the service provision of healthcare facilities and their
achievement of quality and improved patient outcome and hence, as per Davidson et al.
(2017), application of Effective Workplace Culture Framework is effective in small as well as
in large healthcare organisations that are witnessing such concerns which is subsequently
affecting their ability to deliver quality healthcare processes.
Essential attributes
Patient centeredness: As Neonatal Intensive Care Unit hosts paediatric patients that require
thorough intensive and effective care, it is important to ensure that while working in the care
facilities, and dealing with critically ill babies, special care is provided. It is important that all
patients must be provided with special care and attention with the application of a patient-
centred care approach so that the organisation could uphold the vision in terms of quality care
provision and overcome the healthcare concerns and reach to the patients as well as their
family members so that they could also be actively involved in the care process (Fallatah &
Laschinger, 2016; Griffin, 2013).

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Lifelong learning: It is extremely important for the nursing professionals to undergo
continuous professional development and lifelong learning. Nurses within NICU have to deal
with a wide range of paediatric patients that suffer from a multitude of critical illness.
Continuous learning and professional development would facilitate improved performance
output and service delivery.
Open communication or effective communication: While working in the Neonatal Intensive
Care Unit that involves paediatric patients with critical complications, it is important to
maintain an effective and open communication with the multidisciplinary team or
professionals as well as the family members of the patient so that accurate information about
the patient’s condition could be conveyed and a trust could be developed between the family
members of the patient and the team of care professionals. Therefore, this aspect would be
analysed and discussed within the care facility for the growth and development of the process
(Manley et al., 2016).
Teamwork: As the NICU is characterized by excessive patient load, it is important to ensure
positive and effective team work. It is important to ensure that care professionals within the
care unit are able to practice in a collaborate manner so as to render high quality care that
could improve the level of care satisfaction among the patients. It is pivotal for the care
professionals to exhibit elements of compassion and empathy so as to render effective care
delivery and acquire positive patient outcome (Davidson et al., 2017).
Leadership Development: On evaluating the present clinical scenario, it can further be stated
that there is an increased need to integrate leadership development so as to direct the
workforce to achieve a shared goal of fostering high quality care service to the patients to
achieve positive patient outcome (Eskola etal., 2016; Kumar, 2013).
Consequences

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Human Flourishing: The primary consequence that this process could develop is the positive
influence upon the workplace culture and hence as per the discussed factors, providing
patients with effective care quality and improved service helps in achieving positive patient
outcome and improved levels of patient satisfaction (Trastek et al., 2014). Care professionals
would be able to develop skills of effective communication which would ensure open
communication with the patients and inter-professional relationship would also improve
through the application of this process (Eskola et al., 2016; Boamah et al., 2018).
Positive Workplace Culture: The elements of provisioning person-centred care and effective
professional teamwork would help in alleviating patient satisfaction and service outcome.
This would ultimately lead to improved job satisfaction which would help in the
reinforcement of a positive work culture and work environment (Wang & Rafiq, 2014). In
addition to this, integration of refreshment training courses and workshops would also allow
professional development which would help in boosting the skill development of the
employee force.
Recommendations
Hence, upon analysing all these aspects, it can be recommended that the implementation of
patient-centred and family centred care helps to render effective care to the patients and at the
same time, effective and open communication, helps the families of the patients to trust the
care process and assists the family members with counselling so that they could cooperate
with the care process in an improved manner (Real, Roldán & Leal, 2014; Stetler et al.,
2014). Further, application of effective communication would also help the care professionals
to overcome their complex organisational conflicts and this would help to develop teamwork
to render effective care to the patients (Wang & Rafiq, 2014). Therefore, to summarize it can
be mentioned that encouraging patient satisfaction feedback could help in the integration of

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compassion satisfaction and at the same time can also assist with the process of continuous
quality development (Lusk & Fater, 2013). Further, clarifying the professional role of the
workers would also help in efficient management of patient load and ensure a smooth work
process. This would help in avoiding delay or manhandling of the patients (King & Hoppe,
2013). Further, open communication channel with the organizational management can help in
maintaining transparency of the communication process (Rathert et al., 2013). Also, the
adaption of a flexible management could help in proper resolution of organisational issues
and employee conflicts that could hinder the quality of service delivery (Doyle et al., 2013).
In addition to this, incorporation of professional development short training courses could
help in enhancing professional development which could help in improving performance
outcome and the quality of service delivery.

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