Discuss common barriers to change and who is typically involved in blocking change.

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Reference textbook: Sullivan, E.J. (2012). Effective leadership and management in nursing. (8th Ed.). Upper Saddle      River, NJ: Prentice-Hall. ISBN-10: 0132814544 | ISBN-13: 978-0132814546

 

 

Chapters: 5, 9, 11, 12

 

 

4.1 Module IV Overview

MODULE IV

Change, Conflict Management,

Team Building, Communication

Learning Objectives

Module IV concentrates on the following course outcomes—

  • Critique communication processes encountered in practice seen in terms of client and organizational outcomes.
    • There will be discussion of change theories and successful implementation of change. Team building will be presented, including an analysis of team communication. Both management and followership roles will be discussed.

Reading Assignment

Sullivan: 5, 9, 11, 12

Overview

Change defines healthcare and organizations. Today’s organizations are driven by changes in technology, economics, demographics and the need to comply with government rules/regulations and consumer demands for quality affordable care. All of that and more in an environment struggling for financial viability. The professional nurse must understand the process of change, including driving forces of change, change theories and models, communication strategies to effect change and common barriers to change. One of the primary roles of the nurse manager is that of change agent. It is a responsibility of both managers and staff nurses within healthcare organizations to understand the costs and benefits of change. Resistance to change is evidenced in many ways, some common barriers include: fear of unknown, real or perceived stress, loss of status and power, increase in unmet needs. Lewin’s Change Model is a traditionally accepted change model. It incorporates steps for doe implementing planned change. Change is a systematic process and organizations use tools to monitor the process of change. The Havelock Model of Planned Change serves as an additional resource for systematically implementing change.

 

Conflict management, team building and the communication processes of the nursing team are integral in delivering quality patient outcomes. The nurse must understand the importance of cultural diversity in nursing management and how diversity affects care delivery. Finally, the concept of polarity management is introduced to assist nurses in being able to embrace ambiguity and balance mutually important but competing concepts.

 

 

  1. Briefly explain one of the Change theories, including its steps; and how you have seen it used in the organization.  Was it effective or not and if not, why not.
  2. Discuss common barriers to change and who is typically involved in blocking change.
  3. Describe five common approaches to conflict resolution and their effectiveness. How is conflict resolution handled in your organization?
  4. What factors do you think contribute to effective team building?

 

4. Describe the four components of just culture and how you think Just culture contributes to patient safety.

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Sullivan: Chapter 6

IUPUI Library Online

Armitage, G. (2009). Human error theory: Relevance to nursing management. Journal of Nursing Management, 17, 193-202

Despins, L., Scott-Cawiezell, J., & Rouder, J. (2010). Detection of patient risk by nurses: a theoretical framework. Journal of Advanced Nursing, 66(2), 465-474.

Mayer, C.M., Cronin, D., (2008). Organizational accountability in a just culture. Urologic Nursing. 28 (6): p 427-30.

Riley, W. (2009). High reliability and implications for nursing leaders. Journal of Nursing Management, 17(2), 238-246.

 

Key Topics and Definitions to Know:

Six Sigma, Lean Six Sigma, Benchmarking, Standards, Dashboards, Sentinel Events, Root Cause Analysis, Nurse Sensitive Quality Indicators, Anonymous error reporting systems, Just Culture, High Reliable Organizations

Overview

Quality and risk management are major issues in the current healthcare environment. Safety, quality and consumer satisfaction and outcomes are key elements of the healthcare system too. More and more time for all healthcare organizations is being spent determining the best way to meet customer expectations. Understanding the major concepts associated with quality, risk, and consumer relations will assist in developing the staff nurse role. Each health care organization is concerned with safe, quality, efficient, and cost effective care. Anyone of these variables cannot be overlooked in order to focus on one or few. Few consumers will want cost effective care that is not safe or of highest quality.

 

As you will recall from earlier reading, organizations are about structure, process and outcome. Quality improvement is a means to assess and measure on an ongoing systematic say how an organizations is meeting desired outcomes. Key concepts to understand regarding safety and risk in hospitals is based on Norma Accident and High Reliability Theory. High Reliable Organizations (HRO) are those that operate under the premise that something can go wrong, consequently they are always on alert to prevent error by avoiding complacency. Drifting into failure is a term well known to “high risk” professions such as healthcare and aviation. Often times deviation from the standard is seen and experienced and allowed to go on until eventually something catastrophic happens. It is important to not allow the establishment of deviation from what should be. Other safety measures include those associated with Just Culture and include learning from mistakes, reporting mistakes and treating mistakes in a non-punitive fashion. See journal articles listed for this module.

 

Six Sigma is a vision of quality, which equates to about 3.4 defects per million opportunities for each product or service transaction. Six Sigma is a methodology that strives for perfection. Sigma is a statistical term that measures how far a given process deviates from perfection. The central idea behind Six Sigma is that if you can measure how many “defects” you have in a process, you can systematically figure out how to eliminate them and get as close to “zero defects” as possible. To achieve Six Sigma Quality, a process must produce no more than 3.4 defects per million opportunities. An “opportunity” is defined as a chance for nonconformance, or not meeting the required specifications.

 

Quality improvement process has steps similar to nursing process. It involves steps to plan, implement and evaluate. Benchmarks serve as a basis for comparison of “best practice.” These benchmarks have been developed through research and evidence. Healthcare organizations use report cards and score cards to report criteria related to quality and safety.

 

Consumer relationships are crucial to the viability of any organization. There is a common saying that if a customer is satisfied with the service received from a company, he may not tell anyone, however, if a customer receives negative service, he tells at least 20 people. Think of examples that you have had. This principle relates to health care as well. Unhappy patients have many other choices, especially in urban areas. Patient outcomes and patient satisfaction are two different things. Patients may have negative outcomes and still be satisfied with the organization and care. There are a number of variables that influence this and one is customer relations.

 

1. Discuss the process of root cause analysis.  Who is involved in this process?

2. Give an example of a nurse sensitive outcome, defined by the American Nurses Association, and how it is used in your clinical setting.

3. Describe principles of high reliable organizations that you see in the healthcare setting

4. Describe the four components of just culture and how you think Just culture contributes to patient safety.

5. Discuss your experience with the process of reporting sentinel events in an organization. What error reporting mechanism is in place?

1.     When he/she experienced this loss, what emotions, feelings, thought, and physical symptoms did the person experience?

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Personal Analysis of a Major Loss

 

Background: We are all survivors of some type of loss.  Everyone in this class has experienced some type of loss and accompanying grief.  Besides death of a significant other, there are many other types of losses that produce grief.  The purpose of this project is to analyze a loss you have experienced by using concepts you have learned in this course.

 

Listed below are examples of losses that you may write about:

 

1.     The death of someone important to you:

–   A parent, child, sibling, spouse, or other relative

–   A close friend or someone you were romantically involved with.

–   Someone famous that meant a lot to you.

 

2.     The loss of a relationship through:

–   betrayal, divorce, separation, or desertion

–   kidnapping, murder, or disappearance

–   mental illness

–   substance abuse

 

3.     The loss of a job (yours or someone you depended on for support)

4.     Moving away from home, becoming homeless, becoming a refugee.

5.     Loss of physical capacity or ability through illness, accident, the aging process.

6.     The loss of a pet (through death, ran away, was stolen, etc.)

7.     Loss of something valuable to you (home/property destroyed by fire, flood, natural disaster)

8.     Loss of or denial of membership in a group that was important to you.

9.     Loss of respect for, or sense of betrayal by a person, organization, or group that you had previously held in high esteem.  Loss of your reputation.

10.  Loss of trust in others, or loss of self-esteem due to physical, emotional, or sexual abuse.

 

Directions: Please Use These Sub-Headers

 

Part 1: Description of the loss event.  2-3 pages in length.  Write this from the 3rd person point of view to describe the events.

 

Part 2: The Reactions to the Loss:Again, write this from the 3rd person point of view.  Use concepts from the text and your class notes to describe the reaction to the loss.  Do this in 2-3 pages, double-spaced.  Use the APA format to cite specific concepts from the text.

 

Questions to consider when writing Part 2:

1.     When he/she experienced this loss, what emotions, feelings, thought, and physical symptoms did the person experience?

2.     How did this loss affect the person mentally, emotionally, physically, spiritually, socially?

 

3.     Did the person’s reactions to this loss mirror any of the theories of grief in the text?

If yes, describe the similarities.  If not, describe the differences.

 

Part 3: The Current Status. 2-3 pages.  Switch to 1st person for this section.  Describe how you feel now.  How have your feelings, thoughts, reactions changed over time? How has your life changed due to the loss?  What did you learn from this?

Be sure to use concepts from chapters 9, 10, and 11 of the text, a website, class notes, magazine article, other book.  Use APA format.

 

Formatting Instructions:

1.     Title page with your name, class name, class number, assignment name, and date.

2.     Double-spaced. 1” margins on all sides.  12-point font size.  Number pages in top right hand corner.

3.     Make sure you have three separate sections: Part 1; Part 2; Part 3.

4.     Sections 2 & 3 must include connections to concepts found in chapters 9, 10, and 11, a web site that talks about grief/bereavement, or magazine articles, or other book. You should have a minimum of four references, or two for each of sections 2 and 3.

5.     Use APA style to cite the text or other sources that you use.

6.     Include a reference page that lists the sources that you have cited in the text.

 

 

 

 

 

What can healthcare CEOs learn from the information governance practices of large corporations?

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The term “information governance” is well understood in corporate organizations, and in the healthcare environment it is being used with greater frequency than in the past. This is due in large part to health informatics and the use of technology to transmit, store, share, and manipulate data from health records. Data is an organizational asset to be managed and valued.

Policies, controls, procedures and technologies all need to be in alignment in order for an organization to utilize the full value of this asset—information—which is now found everywhere within the organization. The challenges to growing a culture of information governance in healthcare organizations today are significant, but these challenges are still being tackled by corporate America, as you will read in the following article, located in the CSU Library:Information Governance’s Big Payback.

After reading the article, write a 2- to 3-page essay, providing your opinion on these questions:

  1. What surprised you about the results of the survey found in this article?
  2. Which parts of this survey would be applicable to the healthcare environment?
  3. What can healthcare CEOs learn from the information governance practices of large corporations?

Complete your 2- to 3-page response in Microsoft Word using Times New Roman or a similar font, 12 point, double-spaced. Your paper should be formatted according to CSU-Global Guide to Writing and APA Requirements, with any sources and references properly cited.

4. Provide a conclusion summarizing the importance this research article has to clinical practice.

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Scholarly Research Critique (Individual) = 30 points

Grading Criteria

1. Select one nursing research article (quantitative or qualitative) from the list provided by or approved by your faculty.

2. Provide an introduction to the problem.

3. Critique the article using the appropriate guidelines as provided below. You must support (provide rationale) your responses to the questions in each section (you may use your textbook to support your answers).

4. Provide a conclusion summarizing the importance this research article has to clinical practice.

5. APA formatting is required, including appropriate use of APA levels.

6. Research critique should be 5-7 pages (excluding title page and reference page).

7. This assignment must be submitted to turnitin.com.

8. Utilize the APA levels of headings on page 62 of the APA Manual.

9. Refer to rubric for specific grading.

 

Guidlines:

 

Guidelines for Scholarly Research Critique (Individual) = 30 points Qualitative Article

Title

Was the title a good one, suggesting the key phenomenon and the group or community under study?

Abstract

Does the abstract clearly and concisely summarize the main features of the report?

Introduction

Is the phenomenon of interest clearly identified?

Is the problem stated unambiguously?

Literature Review

Does the report summarize the existing body of knowledge related to the problem or phenomenon of interest?

Is the literature review adequate?

Does the literature review lay a solid basis for the new study

Research Questions

Are research questions explicitly stated? If not, is their absence justified?

Method

Research design and research tradition

Is the identified research tradition (if any) congruent with the methods used to collect and analyze data?

Sample and setting

Was the group or population of interest adequately described? Were the setting and sample described in sufficient detail?

Was the best possible method of sampling used to enhance information richness and address the needs of the study?

Was the sample size adequate? Was saturation achieved?

Data collection and measure

Were the methods of gathering data appropriate? Were data gathered through two or more methods to achieve triangulation?

Was a sufficient amount of data gathered? Was the data of sufficient depth and richness?

Procedures

Were data collection and recording procedures adequately described and do they appear appropriate?

Were data collected in a manner that minimized bias or behavioral distortions? Were data collection staff appropriately trained?

Were appropriate procedures used to safeguard the rights of study participants?

Enhancement of rigor

Did the researcher document research procedures and decision processes sufficiently that findings are auditable and confirmable?

Results

Data Analysis

Were the data management (e.g., coding) and data analysis methods sufficiently described?

Was the data analysis strategy compatible with the research tradition and with the nature and type of data gathered?

Did the analysis yield an appropriate product (e.g., theory, taxonomy, thematic pattern, etc.)?

Did the analytic procedure suggest the possibility of biases?

Findings

Were the findings effectively summarized, with good use of experts?

Do the themes adequately capture the meaning of the data? Does it appear that the researcher satisfactorily conceptualized the themes or patterns in the data?

Did the analysis yield an insightful, provocative, and meaningful picture of the phenomenon under investigation?

Theoretical Integration

Are the themes or patterns logically connected to each other to form a convincing and integrated whole?

Were figures, maps, or models used effectively to summarize conceptualizations?

Discussion

Are the findings interpreted within an appropriate social or cultural context?

Are major findings interpreted and discussed within the context of prior studies?

Are the implications consistent with the study’s limitations?

Does the report address the issue of transferability of the findings?

Implications/Recommendations

Do the researchers discuss the implications of the study for clinical practice or future inquiry-and are those implications reasonable?

Global Issue

Was the report well-written, well-organized, and sufficiently detailed for critical analysis?

Was the description of the methods, findings, and interpretations sufficiently rich and vivid?

Summary Assessment

Do the study findings appear to be trustworthy-do you have confidence in the truth value of the results?

Does the study contribute any meaningful evidence that can be used in nursing practice or that is useful to the nursing discipline?

 

ARTICLE TO BASE THIS PAPER ON IS ATTACHED!

Describe the inferential tests that were used in the article (in other words, t-tests and chi-squares). Given the p-values related to the tests, how do you interpret the results?

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Note:

Read the given article carefully and answer the discussion in 200-250 words.  Your answer must be 100% original.

 

Discussion:

Read the following article and address the discussion below;

 

http://www.emedicinehealth.com/bicycle_safety/article_em.htm

 

 

Describe the inferential tests that were used in the article (in other words, t-tests and chi-squares). Given the p-values related to the tests, how do you interpret the results? Are statistically significant findings also clinically significant? What are the recommendations based on this paper? Share some alternate explanations (mediating or intervening variables) for the results of the study.

Briefly describe the four P’s (product, price, place, and promotion) of the marketing campaign. How does the campaign effectively communicate the risks associated with the health condition they are marketing?

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Social Marketing Campaigns

Choose a social marketing campaign that is working to bring awareness regarding a health condition or problem.

Briefly describe the four P’s (product, price, place, and promotion) of the marketing campaign. How does the campaign effectively communicate the risks associated with the health condition they are marketing?

Suggest at least two ways the campaign can improve for future success.

2. If academic institutions become more involved in managed care, what will be the impacts on continuous quality improvement?

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Microsystems and Professional Responsibility

 

Be sure to review the Discussion Board grading rubric in the course Syllabus.

 

For this Discussion Board, a minimum of 300 words is required for the initial response and a minimum of 150 words for responses to your classmates. During this unit, you will discuss the following three questions.

1. What impacts will continuous quality improvement have on medical research?

2. If academic institutions become more involved in managed care, what will be the impacts on continuous quality improvement?

3. What factors are shifting the role of the primary care physician in the future?

2.    Discuss the role that state and local health departments have in healthcare.

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I have the following Case study, it is simply a memo to a perspective employer.  Doesn’t require citations or references. But needs to be in APA format.

 

You will be graduating from college soon with a degree in healthcare management. You are considering different career choices and would like to work for the government. You are thinking of applying to both state and local health departments but are unsure of what types of activities you may be involved with as a healthcare manager. You will present a memo to your potential employer on comparative effectiveness research (CER) recommendations and efforts toward one of the models described in the text: Restrictions of the Introduction and Dissemination of Technology, Restrictions of Choice of Treatment Procedures, Restrictions on Choices of Provider, Quality Improvement, and Cost Savings.

1.    Using the internet, look up the state and local health departments in Rhode Island and provide a brief overview of their activities.

2.    Discuss the role that state and local health departments have in healthcare.

3.    Describe the purpose, function, and mechanisms of the CER Model you recommend.

4.    Identify the benefits of implementing this CER system.