Respond as if replying to what she wrote: Shadowed Leader: Caitlin Laughton is a Master’s

Respond as if replying to what she wrote: Shadowed Leader: Caitlin Laughton is a Master’s prepared Registered Nurse with a focus on healthcare leadership. Nurse Laughton currently serves as the Vice President of Clinical Operations within Convenient MD (CMD). She started her career at CMD as a practice manager 8 years ago and has since moved up in the company and helped them open new clinics and service lines. Nurse Laughton reports appreciation of the LEAN management style within CMD, allowing her to handle many aspects of the leadership role, from day-to-day interactions with staff and unit leaders, to aligning practice to business goals. Much of her time varies from staff interactions, running and attending meetings, interviewing and onboarding providers, and analyzing and leveraging data. She appreciates being able to be involved in all levels of the organization and believes that this allows her to be a better leader. When different leadership styles were reviewed, Nurse Laughton attributes her leadership style to that of a democratic style. She emphasizes the importance of engaging and involving her team throughout all change processes, and she reports she tries her best not to ask her staff to do anything she herself could not do. Nurse Laughton reports that she believes communication and collaboration through the lens of a democratic leadership style helps her to engage and elevate the skills of her team which ultimately increased patient care and outcomes. Convenient MD Convenient MD was originally established back in 2012 as a walk-in urgent care clinic. Noticing a gap in primary care coverage for patients exacerbated by the pandemic, they decided to open a primary care service line. The mission of CMD is to “make good health more convenient for all- working to improve how patients and providers experience healthcare in New England” (ConvenientMD, 2025). Their vision is “Creating a system of good health connecting physical, mental, and financial health. Working to provide convenient access to high-quality care by putting people first” (ConvenientMD, 2025). The primary care service line was only recently established back in 2022 and serves all ages from newborn to geriatrics. Nurse Laughton endorses the largest strength within the setting is their team-based model. She reports that the CMD team culture is based on flexibility, accountability, teamwork and support for one another. Another strength of the system is its focus on value-based care, which provides services based on patient needs and outcomes rather than simply meeting metrics. Talking with staff about this model and being one of the first NH-based primary care clinics to focus on a value-based model has provided a sense of pride in being able to service their patients in a more meaningful way. The team at CMD Primary care is multidisciplinary ensuring clients are served holistically, this team includes nurses, medical assistants, physicians, pharmacists, mid-levels, health coaches and social workers. The team accounts for approximately 65 professional staff members between 4 practices, covering about 13,000 patients. While much of the day-to-day work is overseen by practice managers, providers assess patients and provide point of care orders for nurses and medical assistants to complete. To help increase provider face to face time, the nurses monitor and review inbox messages and send to providers as needed, this decreases the burden on providers as well as encouraging the nurses to work to the extent of their practice in triaging and managing patient needs within their scope. A challenge of the system is that of the Electronic Medical Record (EMR) which is an older model and not always easy to use and find information that is needed. While the overarching software is cumbersome, the additional software, Power BI, allows for data aggregation from the EMR while leveraging its analytic tools to provide consumable metrics. One outcome reviewed in the meeting is that of shingles vaccines provided to Medicare patients. The Shingles vaccine is recommended for those over the age of 65 and intended to prevent debilitating sequalae from complications of the infection (McElhaney, et al., 2019). This analysis looks at all eligible participants compared to the number of vaccinated patients. This is a reported measure to overseeing agencies such as Medicare. A secondary outcome that was measured included hypertension management. High blood pressure is a leading cause of cardiovascular related death (World Health Organization, 2023). It is known as a silent killer and therefore the primary care service has a duty to help manage blood pressure for their clientele to improve patient outcomes (Kalehoff, & Oparil, 2020). At CMD the percentage of patients with abnormal blood pressure readings with a diagnosis of hypertension is reviewed on a monthly basis. This data is then brought back to individual providers as well as the population health team, including the pharmacist for suggested pharmaceutical or lifestyle interventions aimed at improving blood pressure management. Staff Meeting Observation Prior to observing the staff meeting, this writer was able to review data preparation for the meeting with Nurse Laughton. A metrics dashboard was updated for the past month in A1C control, hypertension control and vaccination rates for eligible patients. During this meeting nurse Laughton updated staff on EMR updates, including submission of requests to 5 vendors for quotes with plans for demos involving front-line staff for input on clinical application. This was another example of Nurse Laughton’s push for staff involvement. She reports that in her experience, increasing involvement in planning and decision making, when able, is more likely to increase buy-in and staff adoption of new technologies or practices that are integral for clinical care. As this new EMR system will be a capital expenditure budgetary item, she reviewed the expected financial impact of adopting a new EMR system. As the site observed is a newer clinical practice, and new patients are being onboarded daily into provider panels, the plan for room utilization practices was discussed at length. This new push is to ensure that rooms are being utilized to their full capacity. Within the primary care setting there are two main functions of the room, on-boarding of new patients as well as ensuring access for already established patients for acute and chronic needs. With limited spacing within the facility itself, there is little space for overflow and when there are delays in appointments, with little wiggle room in the schedule, that single delay can throw off a provider’s schedule for the full day. The team discussed the limitations of spacing, room and provider flexibility and how to engage a team-based model to ensure patient needs were being met. Limitations of the EMR system were discussed and tabled related to plans for assessing adopting a new EMR system. Caitlin reviewed and demonstrated different options of altering schedules based on clinical needs and the staff provided input for navigating challenges on the provided clinical scenarios. Ethical and Legal Considerations The main legal consideration reviewed was that of licensing and practice standards. CLIA wavers for point of care testing were discussed and reviewed for lab standards required in order to operate. This included preparation, running and cleaning of labs and lab equipment. Ensuring all providers are meeting licensing regulations was another topic discussed in terms of legal considerations. Nurse Laughton reports they do their best to go over and above requirements including professional development offered and re-licensure standards. Ethical considerations were a much larger topic, as the duty to ensure appropriate and evidence-based care was clear. Staff mentioned during the staff meeting concerns for adequate for especially their geriatric populations. With increasing longevity, they also are more likely to have more comorbidities, and a need for services at home, such as visiting nurses. Staff members expressed a desire to provide the best care possible for geriatric clientele, but report concerns with barriers for access and financial feasibility of establishing needed at-home services. Another ethical standard discussed was the subset of patients who require medical monitoring for disordered eating patterns. Some individuals with malnutrition and other comorbid mental health concerns have become increasingly taxing on the clinics, especially when patients decline needed further mental health support. While CMD does have ethical and legal obligations to provide patients with an adequate standard of care there is no guarantee that patients are agreeable to such interventions. This non-adherence to suggested regimens can increase care burden of facilities with limited resources. Leadership Style and Traits As discussed in the previous section, Nurse Laughton perceives her leadership style is that of a democratic leader. However, through interactions observed in the shadowing experience, this writer would argue that her management style is more of that of a transformative leader. Transformative leaders align work and anticipate challenges of the business with a focus on reaching company goals. Transformational leaders are excellent communicators and collaborators who use their charismatic personalities to influence actions and behaviors of those they lead (Korejan, & Shahbazi, 2016). One specific example to transformational leadership observed was Nurse Laughton providing a practice manager with help on establishing a process improvement plan (PIP) for an employee who was frequently absent from work and whose documentation was not on par with expectations. Nurse Laughton spent much of the time listening to concerns of the practice manager and asking clarifying questions when needed to ensure understanding. She then collaborated with the practice manager what an example of the PIP might look like when they met with the staff member. As this practice manager was newer in this role, Nurse Laughton provided some questions of concern and topics that could be discussed with the staff member to dig deeper on the underlying cause and possible solutions to this problem. This instruction was provided in both verbal conversation as well as an easy-to-use bulleted checklist of needed discussion points for PIP meetings and how to document. It was discussed that Nurse Laughton could be at this meeting for support if desired or there for review of the process depending on the comfortability of the practice manager. After working with Nurse Laughton for about half an hour the practice manager reported that she felt comfortable enough to run the meeting herself but would reach out for guidance if needed. After this interaction, Nurse Laughton expressed that she appreciates being a resource to her team but is also very confident in their abilities to handle most matters on their own. She reports feeling that staff members feel more valued and find their jobs more meaningful when they know they make a difference and have the skill sets to independently work to the extent of their scope, she reports her staff have verbalized appreciation of having defined terms of personal accountability rather than being micro-managed. During the shadowing experience, staff feedback from a quarterly engagement survey was reviewed and data was presented to the team. All the data is broken down by primary versus urgent care, a software called “Culture Amp” aggregates the data and pulls out themes or “hot spots” that help specify the areas to focus on. This data is presented in three main presentation modalities including visual based on clinics verbalized preference of poster, emails, graphs or paragraph forms, verbally at staff meetings and an additional mix of both methods within a power point presentation forum. CMD then ensures they loop back before the end of the quarter to report on the progress of identified action items as well as ongoing work. One main finding of the last survey was frustration with communication and reports of frustration being a mix of both not knowing about changes soon enough as well as feelings of frustration when a new process is brought up but has not been fully solidified yet. Nurse Caitline reports that it is finding a happy medium between the two that is essential. A part of leadership at CMD is making sure staff are communicated with early enough to be involved in a meaningful way but have some plans already in place so they see the purpose and path of the change and not just working on a project from scratch, which can feel overwhelming and burdensome. This happy medium helps to keep staff involved and engaged as they work towards a common goal when they see the purpose and value of their input. Another concern discussed were concerns with the EMR system. Nurse Laughton discussed that a new committee had been established as a result of this feedback system with quarterly reviews to address staff concerns. Stakeholders include LPN, MA, RN, providers and mid-levels to represent their teams to ensure each clinical department has a seat at the table in committees such as the EMR group. This team made decisions on who to submit to for potential EMR vendors and will be involved in the demos and feedback to their teams. Although being on this committee requires extra work on their end, all of the staff on the team had volunteered their time and input into being on this team because they cared about the outcome and making sure their voices were heard. Another committee is the training committee that brings forth new clinical practices and standards. They assess clinical issues and newly advised evidence-based practice techniques. This committee reviews whether the identified problem or new practice is a training concern or workflow issue, and establishes action plans based on their findings. One example of work done by this committee was focusing on prescription refills and how to best manage the workflow for efficiency, accuracy and ease of use for both patients and clinicians. Practical Application This shadowing experience at CMD allowed this writer to get a firsthand look at the benefits of a transformational leadership style. Nurse Laughton has an excellent pulse on the day-to-day work within her clinic, which gained her rapport with the front lines, and helped position her as a content expert and a source of knowledge for her team. She was also sure to empower her staff to own their practice while using social skills to ensure everyone feels valued and important. She communicated the needs of the business when needed and provides space and integrations of ideas, teamwork and differing opinions. While there are always difficult personalities in the workplace, Nurse Laughton was able to set clear boundaries while holding space for people to learn from their mistakes and improve their practice. Caitlin has taught me that community and teamwork when partnered together towards a common goal can create an enjoyable workplace that is able to ebb and flow with the ever-changing nature of healthcare, remaining relevant and ensuring adherence to evidence-based standards. Applying this newly obtained knowledge into practice feels feasible after spending time at CMD. While leadership traits include adaptability, dependability, creativity, intelligence and social skills (Kumar, 2013). This shadowing experience showed me particle tips and tricks for implementing transformational leadership as a school nurse. I see the benefit of involving affected parties early in change management and helping others practice to their full potential within their scopes. Being a leader in school nursing requires patience, persistence, empathy, understanding and excellent communication skills, all of which were observed firsthand with this shadowing experience.

******CLICK ORDER NOW BELOW AND OUR WRITERS WILL WRITE AN ANSWER TO THIS ASSIGNMENT OR ANY OTHER ASSIGNMENT, DISCUSSION, ESSAY, HOMEWORK OR QUESTION YOU MAY HAVE. OUR PAPERS ARE PLAGIARISM FREE*******."