· Analyze how political arenas (government, workplace, professional organizations, and community) shape health care delivery.

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Organizational Structure, Strategic Planning

Care Delivery Models, Safety Culture

Learning Objectives

Module I concentrates on the following course outcomes—

· Analyze how political arenas (government, workplace, professional organizations, and community) shape health care delivery.

o The concept of the organization is introduced to provide context to the planning component of nursing management. Mission, philosophy, vision and values are discussed as impacting the nurse’s practice. Planning patient care in specific team configurations is also discussed.

Federal and consumer directives have forced healthcare organizations to examine current practice models and both organizational structures and processes that account for increasing efforts to develop models and systems that contribute to patient safety. Patient safety is at the forefront of issues for organizations and efforts have begun to identify safety culture dimensions.

The importance of communication within the organization and specifically within structured work teams is discussed. Typical patterns of communication are identified.

Reading Assignment

Sullivan: Chapters 1, 2, 3

Supplemental Readings (See Resources Section)

Beyea, S. C. (2005). High reliability theory and high reliable organizations. AORN Journal. 81(6), 1319-1322.

Cooke, H. (2009). Theories of risk and safety: what is their relevance to nursing? Journal of Nursing Management. 17:256-264.

Air Safety Support International. (2006) Safety Culture. Available at: http://www.airsafety.aero/safety_development/sms/safety_culture/ (Links to an external site.)Accessed July 25, 2012

Overview

Understanding the organizational context of professional nursing practice is an important part of leadership and management. The nurse will participate in determining the most effective strategic plan for implementing care at the bedside or for an entire patient population of a facility. Other contextual factors include the mission, vision and philosophy and organizational culture of the organization. It is important for the nurse to know the mission and vision of the organization and have a philosophy that is consistent with that of the organization in order to support its efforts. Organizational structure relates to how work is organized and and provides for how work is communicated. Classic organizational structures include centralized, decentralized, matrix and combinations of these types. Centralized organizations (tall, with many layers) tend to have decision making at the “top.” While, decentralized organizations (flat) have decision making closer to the level of care. The military is an example of a centralized organization. Modern healthcare have moved toward a more type flat type of structure with decentralization and shared decision making. A concept appropriate to professional personnel. The organizational chart defines chain of command, line versus staff positions, and span of control. These are key concepts to know for this course. System’s Theory, Humanistic Theory, Chaos Theory, Contingency Theory and Complexity Theory are theoretical frameworks used to guide the processes within an organization. Cultural Diversity within organizations relates to both care provider and recipient. The changing demographics require non-biased understanding and appreciation of the difference of others.

Safety Culture has become a major issue for organizations since the IOM report in 1999 citing thousands of hospital errors and patient deaths and establishing a culture of safety has become a healthcare priority. Safety culture has its origin in high risk organizations such. Health care organizations are considered high risk organizations similar to aviation, nuclear plants and chemical process industry. Organizations that perform successfully under exigent conditions are termed high reliable organizations (HRO). Characteristics of high reliable organizations include for example: 1) preoccupation with failure, 2) reluctance to accept simplification and 3) deferring to expertise. Preoccupation with failure is an effort to avoid drifting into failure and becoming complacent. Safety culture is a central foundation of HROs and is measured with a variety of tools to assess communication, teamwork, frequency of error reporting. Expectations of manager behaviors to promote safety and more. The Agency for Health Research and Quality (AHRQ) published the Hospital Survey on Patient Safety Culture (HSOPSC) in 2004 and to date hundreds of hospitals with thousands of healthcare employees have reported perceptions of hospital safety culture with de-identified data reported in aggregate. See information about safety and the HSOPSC at http://www.ahrq.gov/downloads/pub/advances2/vol2/Advances-Jones_29.pdf (Links to an external site.). Safety and safety culture information will be discussed again in Module V along with Quality improvement and literature related to healthcare errors.

“Nursing work” is organized according to different models for care delivery. Functional, Team Leading, Differentiated Practice, Primary Nursing and Care Management Method are common delivery models. Differentiated practice is a model more commonly seen within Magnet hospitals systems and includes provision for the different levels of educational preparation and skill of the Registered Nurses with different job descriptions for each. The type of delivery system depends on a number of factors, including availability of staff, staff mix, type of patients and organizational philosophy. The ultimate goal is a safe environment with quality and financially sound outcomes.

Strategic planning is vital to any organization and is carried out in a systematic process. It includes identifying the organization’s strengths and weaknesses through assessment of the internal and external environment. The process screens for influencing markets, competition, technology, healthcare trends, financial resources and information systems to name a few.

Assignment questions: Post answers in Forums Module I. See calendar for due date.

1. Discuss one of the organizational theories from the readings and how you see this theory used or could be used in an organization. What are the merits of the theory?

2. Discuss what is meant by the terms, organizational span of control and chain of command.

3. Describe three types of organizational structures and some characteristics. Which type of organizational structure have you seen used in an organization and what are its advantages and limitations.

4. Which type of organizational structures do we see most frequently in acute care hospitals?

5. Cite common factors used for strategic planning and how nurses are involved in the process.

 

Explain the pathophysiology of the disorders depicted in the scenarios, including their associated alterations. Be sure to describe the patients’ adaptive responses to the alterations.

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Scenario 1: Jennifer is a 2­year­old female who presents with her mother. Mom is concerned because Jennifer has been “running a temperature” for the last 3 days.  Mom says that Jennifer is usually healthy and has no significant medical history. She was in her usual state of good health until 3 days ago when she started to get fussy, would not eat her breakfast, and would not sit still for her favorite television cartoon. Since then she has had a fever off and on, anywhere between 101oF and today’s high of 103.2oF. Mom has been giving her ibuprofen, but when the fever went up to 103.2oF today, she felt that she should come in for evaluation. A physical examination reveals a height and weight appropriate 2­year­old female who appears acutely unwell.  Her skin is hot and dry. The tympanic membranes are slightly reddened on the periphery, but otherwise normal in appearance. The throat is erythematous with 4+ tonsils and diffuse exudates. Anterior cervical nodes are readily palpable and clearly tender to touch on the left side. The child indicates that her throat hurts “a lot” and it is painful to swallow. Vital signs reveal a temperature of 102.8oF, a pulse of 128 beats per minute, and a respiratory rate of 24 beats per minute.

 

Scenario 2: Jack is a 27­year­old male who presents with redness and irritation of his hands. He reports that he has never had a problem like this before, but about 2 weeks ago he noticed that both his hands seemed to be really red and flaky. He denies any discomfort, stating that sometimes they feel “a little bit hot,” but otherwise they feel fine. He does not understand why they are so red. His wife told him that he might have an allergy and he should get some steroid cream. Jack has no known allergies and no significant medical history except for recurrent ear infections as a child. He denies any traumatic injury or known exposure to irritants. He is a maintenance engineer in a newspaper building and admits that he often works with abrasive solvents and chemicals. Normally he wears protective gloves, but lately they seem to be in short supply so sometimes he does not use them. He has exposed his hands to some of these cleaning fluids, but says that it never hurt and he always washed his hands when he was finished.

 

Scenario 3: Martha is a 65­year­old woman who recently retired from her job as an administrative assistant at a local hospital. Her medical history is significant for hypertension, which has been controlled for years with

hydrochlorothiazide. She reports that lately she is having a lot of trouble sleeping, she occasionally feels like she has a “racing heartbeat,” and she is losing her appetite. She emphasizes that she is not hungry like she used to be. The only significant change that has occurred lately in her life is that her 87­year­old mother moved into her home a few years ago. Mom had always been healthy, but she fell down a flight of stairs and broke her hip. Her recovery was a difficult one, as she has lost a lot of mobility and independence and needs to rely on her daughter for assistance with activities of daily living. Martha says it is not the retirement she dreamed about, but she is an only child and is happy to care for her mother. Mom wakes up early in the morning, likes to bathe every day, and has always eaten 5 small meals daily. Martha has to put a lot of time into caring for her mother, so it is almost a “blessing” that Martha is sleeping and eating less. She is worried about her own health though and wants to know why, at her age, she suddenly needs less sleep.

To prepare:

Review the three scenarios, as well as Chapter 6 in the Huether and McCance text. Identify the pathophysiology of the disorders presented in the scenarios, including their associated alterations. Consider the adaptive responses to the alterations. Review the “Mind Maps—Dementia, Endocarditis, and Gastro­oesophageal Reflux Disease (GERD)” media in this week’s Learning Resources. Then select one of the disorders you identified from the scenarios. Use the examples in the media as a guide to construct a mind map for the disorder you selected. Consider the epidemiology, pathophysiology, risk factors, clinical presentation, and diagnosis of the disorder, as well as any adaptive responses to alterations.

 

To complete:

Write a 2­ to 3­page paper that addresses the following:

Explain the pathophysiology of the disorders depicted in the scenarios, including their associated alterations. Be sure to describe the patients’ adaptive responses to the alterations. Construct a mind map of your selected disorder. Include the epidemiology, pathophysiology, risk factors, clinical presentation, and diagnosis of the disorder, as well as any adaptive responses to alterations.

 

The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at http://writingcenter.waldenu.edu/57.htm). All papers submitted must use this formatting.

 

Describe a department or unit within a health care organization using systems theory terminology. Include a description of inputs, throughput, output, cycles of events, and negative feedback.

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Write a 3- to 5-page paper (page count does not include title and reference page) that addresses the following:

  • Describe a department or unit within a health care organization using systems theory terminology. Include a description of inputs, throughput, output, cycles of events, and negative feedback.
  • Describe the problem you identified within the department or unit using an open- systems approach, and state where the problem exists using the systems theory model (input, throughput, output, cycles of events, or negative feedback).
  • Based on this information, explain how you would address the problem as follows:
    • Formulate a desired outcome.
    • Identify goals and objectives that would facilitate that outcome.
    • Translate those goals and objectives into policies and procedures for the department or unit.
    • Describe relevant professional standards.
  • Explain how your proposed resolution to the problem would uphold the organization’s mission and values and improve the culture and climate.

Identify the pathophysiology of the disorders presented in the scenarios, including their associated alterations. Consider the adaptive responses to the alterations.

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Consider the following scenarios:

Scenario 1:
Jennifer is a 2-year-old female who presents with her mother. Mom is concerned because Jennifer has been “running a temperature” for the last 3 days.  Mom says that Jennifer is usually healthy and has no significant medical history. She was in her usual state of good health until 3 days ago when she started to get fussy, would not eat her breakfast, and would not sit still for her favorite television cartoon. Since then she has had a fever off and on, anywhere between 101oF and today’s high of 103.2oF. Mom has been giving her ibuprofen, but when the fever went up to 103.2oF today, she felt that she should come in for evaluation. A physical examination reveals a height and weight appropriate 2-year-old female who appears acutely unwell.  Her skin is hot and dry. The tympanic membranes are slightly reddened on the periphery, but otherwise normal in appearance. The throat is erythematous with 4+ tonsils and diffuse exudates. Anterior cervical nodes are readily palpable and clearly tender to touch on the left side. The child indicates that her throat hurts “a lot” and it is painful to swallow. Vital signs reveal a temperature of 102.8oF, a pulse of 128 beats per minute, and a respiratory rate of 24 beats per minute.

Scenario 2:
Jack is a 27-year-old male who presents with redness and irritation of his hands. He reports that he has never had a problem like this before, but about 2 weeks ago he noticed that both his hands seemed to be really red and flaky. He denies any discomfort, stating that sometimes they feel “a little bit hot,” but otherwise they feel fine. He does not understand why they are so red. His wife told him that he might have an allergy and he should get some steroid cream. Jack has no known allergies and no significant medical history except for recurrent ear infections as a child. He denies any traumatic injury or known exposure to irritants. He is a maintenance engineer in a newspaper building and admits that he often works with abrasive solvents and chemicals. Normally he wears protective gloves, but lately they seem to be in short supply so sometimes he does not use them. He has exposed his hands to some of these cleaning fluids, but says that it never hurt and he always washed his hands when he was finished.

Scenario 3:
Martha is a 65-year-old woman who recently retired from her job as an administrative assistant at a local hospital. Her medical history is significant for hypertension, which has been controlled for years with hydrochlorothiazide. She reports that lately she is having a lot of trouble sleeping, she occasionally feels like she has a “racing heartbeat,” and she is losing her appetite. She emphasizes that she is not hungry like she used to be. The only significant change that has occurred lately in her life is that her 87-year-old mother moved into her home a few years ago. Mom had always been healthy, but she fell down a flight of stairs and broke her hip. Her recovery was a difficult one, as she has lost a lot of mobility and independence and needs to rely on her daughter for assistance with activities of daily living. Martha says it is not the retirement she dreamed about, but she is an only child and is happy to care for her mother. Mom wakes up early in the morning, likes to bathe every day, and has always eaten 5 small meals daily. Martha has to put a lot of time into caring for her mother, so it is almost a “blessing” that Martha is sleeping and eating less. She is worried about her own health though and wants to know why, at her age, she suddenly needs less sleep.

To prepare:

  • Review the three scenarios, as well as Chapter 6 in the Huether and McCance text.
  • Identify the pathophysiology of the disorders presented in the scenarios, including their associated alterations. Consider the adaptive responses to the alterations.
  • Review the “Mind Maps—Dementia, Endocarditis, and Gastro-oesophageal Reflux Disease (GERD)” media in this week’s Learning Resources. Then select one of the disorders you identified from the scenarios. Use the examples in the media as a guide to construct a mind map for the disorder you selected. Consider the epidemiology, pathophysiology, risk factors, clinical presentation, and diagnosis of the disorder, as well as any adaptive responses to alterations.

To complete:

Write a 2- to 3-page paper that addresses the following:

  • Explain the pathophysiology of the disorders depicted in the scenarios, including their associated alterations. Be sure to describe the patients’ adaptive responses to the alterations.
  • Construct a mind map of your selected disorder. Include the epidemiology, pathophysiology, risk factors, clinical presentation, and diagnosis of the disorder, as well as any adaptive responses to alterations.

Describe the structure or system using the Health Care Structures Worksheet.

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Choose one health care structure or delivery system from your readings or vocabulary exercise this week that most interests you, personally or professionally.

 

Describe the structure or system using the Health Care Structures Worksheet.

 

Use at least one reference.

 

PLEASE DO NOT PLAGERIZE. MY SCHOOL IS VERY STRICT WITH THAT!!! AND TURN IN ON TIME PLEASE AND THANK YOU AN ADVANCE FOR YOU WORK!. 🙂

Which approach to family therapy would be ideal for this family (e.g., structural, solution-focused, Bowenian)? Explain your thoughts and support your choices with aspects of the text or other scholarly sources.

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Unit 9: Unit 9: Comparative Psychotherapies – Discussion

Discussions are fundamental to shared learning, so please be sure to participate early and often! After you have completed the Reading, and without reviewing your classmate’s responses, post your initial response to the following Discussion. Your post should be at least 300-350 words in length and should extend the discussion of the group supported by your course materials and/or other appropriate resources. After you have submitted your initial post, review some of your classmates’ posts, and respond to at least 2 of your classmates. Your responses to others should be at least 100 words in length and substantive. Refer to your Discussion Board Rubric in your Syllabus for specific grading explanation.

Topics

Family Therapy Case Study

Family Therapy Case Study

For this activity, watch the video: Family Therapy Case Study. Use the information in the scenario to answer the following questions:

Inez and Joseph are a married couple with a 7-year-old son, Leo. Leo is in second grade, but Leo has been refusing to go to school for several weeks. Sometimes, Inez and Joseph are able to coax or force him to go to school, but other times, he stays home the entire day. Almost every school-day morning begins with Leo refusing to get dressed to go to school. Inez and Joseph have been unable to overcome this refusal, and if they try to dress him themselves, he squirms, runs out of the room, cries, and screams. Leo’s behavior has caused significant strain on the marriage. Inez and Joseph frequently and intensely argue about the ideal way to handle Leo. Generally, Inez is more sympathetic and concerned about exploring underlying roots of his behavior, whereas Joseph prefers to make hard-and-fast rules or demands that will force Leo to behave more appropriately regarding of any underlying causes. There is significantly more hostility and less warmth in the home since Leo began this behavior, and Inez and Joseph are concerned that the problem is not improving. They seek the help of Dr. Gollum, a clinical psychologist who practices family therapy.

  • Which approach to family therapy would be ideal for this family (e.g., structural, solution-focused, Bowenian)? Explain your thoughts and support your choices with aspects of the text or other scholarly sources.
  • Is family therapy preferable to other options, such as individual therapy for Leo or parent training for Inez and Joseph? Explain your thoughts and support your choices with aspects of the text or other scholarly sources.
  • What would be the most valid measure of psychotherapy outcome for this case? Explain your thoughts and support your choices with aspects of the text or other scholarly sources.

Cite your textbook and online source(s) according to APA format. Be sure to include both an in-text citation for each scholarly source, and also a complete reference

Improving Usability and interoperability are major issues to consider in the development of Healthcare Information Systems (HIS). How does your organization address these issues?

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Discussion

 

Improving Usability and interoperability are major issues to consider in the development of Healthcare Information Systems (HIS). How does your organization address these issues? Does the transfer of information occur smoothly, or do you need to re-enter data from one application to the next, e.g., patient information from the emergency room does not transfer along with the patient who is admitted to the critical care unit? Or, the patient is discharged and the home care nurses have to “start from scratch” as they prepare the patient’s plan of care.

1) Write a paper (750-1,000 words) regarding the use of the Spearman rank correlation coefficient by Messina, et al. in "The Relationship between Patient Satisfaction and Inpatient Admissions Across Teaching and Nonteaching Hospitals," listed in the module readings.

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Details: 1) Write a paper (750-1,000 words) regarding the use of the Spearman rank correlation coefficient by Messina, et al. in “The Relationship between Patient Satisfaction and Inpatient Admissions Across Teaching and Nonteaching Hospitals,” listed in the module readings. 2) Comment on what variables were used; whether it answered the research question; and whether the Spearman rank correlation coefficient is appropriately used, given the requirements of the Spearman rank correlation coefficient. 3) Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. 4) This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.]]>

1) Write a paper (750-1,000 words) regarding the use of the Spearman rank correlation coefficient by Messina, et al. in “The Relationship between Patient Satisfaction and Inpatient Admissions Across Teaching and Nonteaching Hospitals,” listed in the module readings.

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Details:

1) Write a paper (750-1,000 words) regarding the use of the Spearman rank correlation coefficient by Messina, et al. in “The Relationship between Patient Satisfaction and Inpatient Admissions Across Teaching and Nonteaching Hospitals,” listed in the module readings.

2) Comment on what variables were used; whether it answered the research question; and whether the Spearman rank correlation coefficient is appropriately used, given the requirements of the Spearman rank correlation coefficient.

3) Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

4) This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.