Main Discussion Post

        The administrator has been informed that the nursing home’s ER use is higher than necessary. The situation is best served by transformational leadership. This transformative leadership approach requires accountability from every nursing home staff member. I would counsel the staff to aim for the most significant levels of performance while instructing them to maintain a positive mindset rather than taking on a negative or discouraging attitude (Yoder-Wise, 2018).

        Being an active participant in the transformation process, I’d help the nurse manager look at ways to reduce the number of ER visits and analyze the nurse-to-patient ratio. According to the Centers for Disease Control and Prevention, many emergency room visits by nursing care residents might be avoided with higher nurse staffing levels (CDC 2017). More time to treat severely ill patients can prevent appropriate medical care from being provided. This is a consequence of inadequate personnel. To compensate for the nursing home’s lack of medical treatment, the ER acts as medical coverage. Using the information from the staffing analysis, I will alter the personnel accordingly, and I’ll nudge the present team to cooperate and deliver the same level of care.

         For my second intervention, I’ll research the variables associated with individuals who require hospital admission. As a result, procedures and interventions for better care will be developed, and we will better understand the factors that lead to the transfer of nursing home patients to the emergency room (Perrin et al., 2017). I would start by creating emergency procedures to look at the medical complaints presented in a medical emergency and numerous other medical conditions to develop a strategy to deal with medical emergencies better. Specific techniques would be used to help the nursing team finish a thorough examination of the medical complaint. When it comes to the directive degree of care, the evaluation’s results will serve as the guiding principles. I would ask the ED Utilization Review to reduce the number of pointless ED visits and determine the underlying causes of those visits and why they considered the ED had been exploited. Making it easier to determine whether advanced emergency hospital care is necessary will help reduce unnecessary emergency transfers to the hospital. 


Perrin, A., Tavassoli, N., Mathieu, C., Hermabessière, S., Houles, M., McCambridge, C., … &Rolland, Y. (2017). Factors predisposing nursing home     

     resident to inappropriate transfer to the emergency department. The FINE study protocol. Contemporary Clinical Trials Communications7, 217-223.      to an external site.

Centers for Disease Control and Prevention. (2017). NCHS Data Brief, No. 33. Retrieved

      from to an external site.

Yoder-Wise, P. (2018). Leading and managing in nursing. St. Louis, MO: Mosby

In scenario one, a hospital is complaining that the nursing home is sending too many patients to the emergency room that do not necessarily require emergency care. The hope is that the nursing home can manage these issues as part of a fully integrated network with many provider resources to address these medical issues appropriately. Many patients are transferred to the ED for acute care (Lemoyne, 2019). The aging population is increasing yearly, with a projected 24% of people over 65 by 2030 (Lemoyne, 2019). Since this nursing home is a for-profit facility that is part of a more extensive system, we can apply strategies we learned to start decreasing unnecessary ED visits and have these problems addressed in-house.

The most appropriate leadership style and strategy I suggest we utilize is the transformational leadership style. We use this style when significant changes are needed, and overall patient care needs to be improved (Yoder-Wise, 2018). We know from the ED feedback that they don’t think these patients need to be seen by the ED, so we need to figure out the top reasons these patients are being sent over and what we can have on hand and staff members on board that can solve these issues in the house. Dealing with a prominent Alzheimer’s population can be complex for patients to take care of. Investing in staff training and education for this specific disease will help the floor nurses better take care of our patients and hopefully avoid unnecessary visits out of the facility. Compiling a list of the top medical issues that Alzheimer’s patients commonly experience and comparing that to the problems the ED is seeing our patients for can narrow down the training we need to focus on.

Choosing this leadership style allows the management to focus on significant improvements that need to happen. This method motivates the staff and will enable them to take ownership of their actions and outcomes. This method is my favorite because it sets clear goals and has high expectations. A support and recognition technique tends to have better results (Morales, 2020). Utilizing this will decrease the number of unnecessary ED visits from the nursing home facility.


Lemoyne, S.E., Herbots, H.H., De Blick, D. (2019, January). Appropriateness of transferring nursing home residents to emergency departments: a systematic review. BMC Geriatr. to an external site.

Morales, M. (2020, January). Characteristics and Examples of Transformational Leadership in Nursing. Relias. Retrieved from

Yoder-Wise, P. (2018). Leading and managing in nursing. St. Louis, MO: Mosby

I agree with the use of the transformational leadership style in this scenario. This style effectively addresses the current problem of unnecessary ED visits from the nursing home and improves overall patient care. By focusing on significant changes and setting clear goals and high expectations, the management and staff members can work towards a common goal of providing quality care to patients within the facility.

The recommendation to invest in staff training and education for Alzheimer’s disease is an excellent step toward addressing the issue. By focusing on the specific medical issues common in Alzheimer’s patients, the staff will be better equipped to handle these patients and avoid unnecessary ED visits (Lemoyne et al., 2019). This approach aligns with the transformational leadership style as it empowers the staff to take ownership of their actions and outcomes and provides them with the resources they need to be successful.

Additionally, it is essential to remember that the aging population is increasing, and the projected growth in the number of people over 65 by 2030 means that the demand for healthcare services will also increase (Lemoyne et al., 2019). By utilizing the transformational leadership style, we can ensure that the nursing home is well-equipped to handle the growing demand for services and provide high-quality patient care. This can be achieved through ongoing staff training and education, utilizing technology and other resources, and fostering a culture of continuous improvement.

In conclusion, transformational leadership is the best approach to address the problem of unnecessary ED visits from the nursing home. By setting clear goals, empowering staff members, and investing in education and training, we can improve patient care and provide a better experience for both patients and staff members.


Lemoyne, S.E., Herbots, H.H., De Blick, D. (2019, January). Appropriateness of transferring nursing home residents to emergency departments: a systematic review. BMC Geriatr.

# Scenario 1

The first scenario gives us a case where a nursing home is being accused of sending too many patients to the Emergency Department(ED), yet most of these patients do not need ED services. From this complaint, the nurse manager is tasked with coming up with a working plan, that the nursing home can use and reduce the number of ED visits. A solution is required, and the solution calls for making use of leadership and management skills. These skills need to focus on improved performance, job satisfaction, and motivation of the nursing staff. The leadership plan and style chosen will also lead to better patient outcomes both at the ED and nursing home. A reduced flow of patients sent to the ED requires additional resources, which are reduced once the issue is solved. It is important to note that the leadership style chosen needs to benefit both the patients and staff members.

The goal can be met, but it takes a leader who understands the gap present and different styles for leadership and knows which style to use to fill in the gap. From my analysis, the transformational leadership style would be the ideal style for use. According to Robbins & Davidhizar. (2020), the style has a positive way of motivating the employees to own their roles, and perform their duties as expected. A transformative leader does not rigidly assign tasks. Instead, this leader empowers the staff, and in this case nursing staff, on thinking of a patient as an individual. The style also teaches the personnel to think beyond when giving patient care, rather than doing a task because they have been told to do it that way.

Research indicates that some organizations, that have used this style have been successful (Figueroa et al.,2019). According to Perez. (2021), the continuous use of this style has a way of motivating the staff to achieve the set goals. Critical thinking enables anyone to solve issues that would have been solved without asking for unnecessary help. Once transformational leadership has been applied in the nursing home, the staff are afterward taught that it is only under certain cases that patients can be transferred to the ED. Anything else is handled by the nursing home.


Figueroa, C. A., Harrison, R., Chauhan, A., & Meyer, L. (2019). Priorities and challenges for health leadership and workforce management globally: a rapid review. BMC health services research19(1), 1-11.

Perez, J. (2021). Leadership in healthcare: transitioning from clinical professional to healthcare leader. Journal of Healthcare Management66(4), 280-302.  DOI: 10.1097/JHM-D-20-00057

Robbins, B., & Davidhizar, R. (2020). Transformational leadership in health care today. The Health Care Manager39(3), 117-121.  DOI: 10.1097/HCM.0000000000000296