REPLY TO THE FOLLOWING TWO DISCUSSIONS 100 WORDS 1 REFERENCE EACH#1 Yulier Rodriguez Medina“Communication is defined as act of communicating, or the exchange of information between individuals or groups”In healthcare facilities, nurses can be found nearly everywhere—at patient screenings, in nursing stations, and, most importantly, with the patient in the exam room or at the bedside. Nurses are on the front lines of patient care, making nurse-patient communication essential to a positive patient experience.The core communication components highlight the two main goals in nurse-patient communication:· Creating a positive, warm, and compassionate patient experience· Creating meaningful patient engagement and delivering patient educationUnderstanding patient needs and concerns allows nurses to target their communication and clinical strategies toward specific patient preferences. Being an attentive clinician is important to the overall patient experience because it is instrumental in reducing avoidable patient harms. When a nurse is a good listener and frequently checks in on her patients, she is able to reduce both physical and emotional distress.As a leader of a team, there is an opportunity to assess your performance in the three key components of spoken face-to-face communication: words, tone, and body language. Words may not be as easy to adjust, as they are often driven by the message and, in the clinical world, common by profession.( Pamela Hunt; Deborah Laughon, 2019) Tone is a little more challenging. You might not be aware of your tone, especially if the message is critical or emotional. Once you are aware of issues, you can be more purposeful about your approach. The last of these components and probably the most critical is body language. Begin by paying attention to your audience – they are telling you something. Look carefully at the audience and how they are responding to your message. Be prepared to adjust your approach based on what you are seeing. In Leadership Simplified, Van Dyke noted the importance of managing the following non-verbal cues:§ Good eye contact§ Be conscious of where your hands and arms are (crossed arms represent disinterest)§ Control facial expressions, especially scowls§ Posture: leaning forward (interested) or leaning backward (disinterested)§ Neck and forehead rubbing (stress)§ Nodding “yes” and “Um-hums” (represent listening)§ Be mindful of gesturing (limit to emphasize key points) The impact of Healthcare Facility Design on teamwork Teamwork and communication are behavioral factors that are impacted by physical design. However, the effects of environmental factors on teamwork and communication have not been investigated extensively in healthcare design literature. There are no published systematic reviews on the current topic. Several studies have shown the importance of family support spaces to encourage family presence to benefit patient recovery. Diverse family outcomes, in relation to healthcare building design, include psychological support, accessibility, and satisfaction with care (DuBose et al., 2018;)Physical design is a factor in managing ED security issues. Access control (by both direct and electronic surveillance) and observation of visitor reception areas are the most cited factors in healthcare design literature, and at least eight aspects of design have been mentioned to minimize security risks in facilities.( Chan, D. C. (2016).) Most of these studies are relevant to EDs, and other studies’ findings are applicable to the scope of this research. A systematic review regarding the impact of environmental design on teamwork and communication. Providing enough space in work stations, patient rooms and corridors is recommended to support team member collaboration, accommodate supplies nearby and maintain proximity to services. Generally, efforts to make the environment supportive of patient needs must also consider the needs of the staff. (Bosch, S., Gharaveis, A. (2017)For instance, the physical environment could include spaces designed to allow team members to work together, face to face, and to accommodate supplies nearby, such as rooms for medical products and storage facilities.High levels of visibility impact productivity and efficiency of teamwork and communication and improve the chance of lowering security issues. It may also contribute to the general body of knowledge about the effect of physical design on teamwork, collaborative communication, and security.( Gharaveis, A., Hamilton, D. K., Pati, D. (2018). ReferencesBosch, S., Gharaveis, A. (2017). Flying solo: A review of the literature on space management and Applied Ergonomics, 58(2), 327–333.Chan, D. C. (2016). Teamwork and moral hazard: Evidence from the emergency department. Journal of Political Economy, 124(3), 734–770.Gharaveis, A., Hamilton, D. K., Pati, D. (2018). The impact of environmental design on teamwork and communication in healthcare facilities—A systematic literature review. Health Environments Research & Design Journal, 11(1) 119–137. doi:10.1177/1937586717730333Pamela Hunt; Deborah Laughon, 2019; “The leaders guide” Fgted/ DelawareSnap./150047-502-529hp#2 Yulier Rodriguez MedinaIntegrated health systems are widely considered to provide superior performance in terms of quality and safety as a result of effective communication and standardized protocols, although these outcomes have not been fully demonstrated (Nelly D. Oelke,). Despite the growing enthusiasm for integration, information related to implementing and evaluating integration-related initiatives is dispersed and not easily accessible. There is little guidance for planners and decision-makers on how to plan and implement integrated health systems. There is a need to seek out and apply current knowledge on health systems integration to advance effective service delivery. Systematic reviews can serve as a tool for evidence-based decision-making for health planners and policy makers.This statements are based on recommendations for systematic review for evidence-based clinical practice. One principle of integrated health systems is the comprehensive scope of clinical and health-related services covered. Integrated health systems assume the responsibility to plan for, provide/purchase and coordinate all core services along the continuum of health for the population served.Evidenced based leadership strategies suggest improvement rooting the system for perfection, (Rogers and Sheaff; 2014-2016)remind us that the “justification for integrated delivery systems is to meet patients’ needs rather than providers’”. Organizations that fail to place the patient at the center of their integration efforts are unlikely to succeed. Integrated health systems should be easy for patients to navigate, and the importance of involving and being representative of the communities served has been stressed. Patient engagement and participation is desired, and consumers are presented with opportunities for input on various levels (Hunter’s; Watts 2019; Advocacy and neglect).ReferencesHunter’s; Watt 2019 rwed) Advocacy and neglect.- Integrated Care. Journal of Integrated Care. 1999;3:155–61.Nelly D. Oelke, Research and Evaluation Consultant with the Health Systems and Workforce Research Unit, Alberta Health Services, Calgary.Research and Evaluation Consultant with the Health Systems and Workforce Research Unit, Alberta Health Services, Calgary.Rogers A, Sheaff R. Formal and Informal Systems of Primary Healthcare in an Integrated System: Evidence from the United States. Healthcare Papers. 2014-2016;1:47–58.

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