Karen also states that “communication with co-workers is fundamental to achieve a common goal and is a crucial component in influencing the staff to engage”. As nurses face an increase pressure from many directions whether it is to improve patient care or in adapting to persistent nursing staff shortages; effective communication can enhance the nurse’s ability to be proactive in critical situation and improve their overall productivity in everyday activities. My second SMART goal is to work with physicians and case management to decrease the length of stay of CHF patients in our facility. Decreasing length of stay has become top priority for many hospitals. An increase in the length of stay has translated into millions of dollars in expenses each year for hospitals. Extended hospital stays add work to an already overburdened staff, creating a less efficient work environment and requiring more resources from overstrained hospital funds. In the article Use of Multidisciplinary Rounds to Simultaneously Improve Quality Outcomes, Enhance Resident Education, and Shorten Length of Stay; the authors describe the challenge in decreasing the length of stay while allocating appropriate resources. The article suggests that “Multidisciplinary teams broadening their scope to the general inpatient medical wards have produced improvements in satisfaction and LOS” (O'Mahony, Mazur, Charney, Wang, & Fine, 2007). The article proposes that utilizing a multidisciplinary approach