Delegation in the Primary Setting
Hello Everyone!
Palanan Health Center Primary Care Facility is a twenty-four hours operational facility for urgent and OPD cases whose main goal is to decongest the patients from Ospital ng Makati, mostly stabilization and refer for further management in OSMAK if there were no improvements. Consequently, way back in 2014 we did not handle DOH programs which have targets that should be monitored quarterly for accomplishment and that should be attained. So then the delegation and monitoring of the staff during that time was not so challenging i guess also because we are only around 30 health care personnel during that time. Now, we are about 50 personnel that I have to manage together with our head physician and oversee the operation on a day-to-day basis.
On this note, delegation of tasks in the facility depends on the job description and roles and responsibility to which type of personnel. We have our utility, BHW, the ambulance driver, nursing attendants, administrative officer, IT officer, supply officer, midwives, nurses and clinicians. Likewise, for the orderly operation of the facility I have directed a charge nurse every duty that will monitor the operation on behalf of my absence. The charge nurse then will coordinate with me.
Additionally, I am currently the program point person for the National Tuberculosis Program and in order for me to handle the program in an organized manner I suggested to our head of the facility that I will assign staff members that will assist me further in managing and overseeing the program on behalf of my absence if I am not on-duty. Overall, we have 3RNs, and 1 RM handling the National Tuberculosis Program and I designated them on different responsibilities. 1 nursing staff is to monitor the inventory of the TB medications, 1 nursing staff is to oversee that the Presumptive Masterlist and the TB Registry logbook is well-organized and updated, and finally, Midwife staff to always update the Integrated Tuberculosis Information System (ITIS) and myself to monitor all of this.
What are the indicators of success or failures if any, and the lessons learned?
In the facility, I think the key Indicator of success when assigning a Charge Nurse is when they are able to smoothly handle the operation of the facility, when there is no complaint from our patients, all the staff performing efficiently to their responsibilities, and those endorsed tasks were accomplished during their shifts. In regards to the TB Program, the success indicator I guess is when I check all the files, inventory, and the ITIS, they are organized and updated and the target for this program was met.
Indicators of Failures for a Charge Nurse were clear when there are no tasks accomplished and a lot of patient errors or complaints. Possibly, the staff were not obedient to the Charge Nurse or personnel inattentive with their responsibilities during their duty. For the TB Program, possibly when there are disorganized files and documents, no update in the ITIS and in the inventory.
For over a year being the Head Nurse of the Palanan Primary Care facility, which is a specialized unit of the Makati Health Department, there are a lot of Lessonsthat i Learned so far when it comes to delegation. When appointing a task to the staff I see to it that I know her/his level of competency, adaptability and potential skills which can help aid towards success and fluently accomplishing the tasks. Henceforward, when the task was not accomplished, I further inquired to them in an decent way why such a task was not done and further Investigation for patient errors or complaints were always both sides, and strategize how to avoid such things then planned out with the staff during our monthly meetings.
Blessed day to all!