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ORGANIZING
THE 21st CENTURY
CHANGING PEOPLE
FOCUS ON THE JOURNEY
NOT JUST POLITICAL
100
A FRAMEWORK FOR DEFINING MANAGERIAL AUTHORITY, RESPONSIBILITY & DECISION MAKING PROCESS
What is AN ORGANIZATIONAL STRUCTURE? Keep in mind rank & hierarchy are evident with the highest position being on the top When it stops being effective, which happens when an organization grows bigger or becomes ineffective, the informal structure fills in the gaps with communication & relationships (grapevine)
100
BOARD MEMBERS, PHYSICIANS, NURSES & MANAGEMENT FORM A CONGRESSIONAL FORMAT COUNCIL
What is SHARED GOVERNANCE? Most innovative & idealistic structures developed in mid 80's as an alternate to bureaucratic structures. It gives nurses more power & control. Difficult to maintain because commitment required.
100
DERIVED FROM THE LATIN VERB "POTERE" (TO BE ABLE TO)
What is THE WORD "POWER"? Which can be interpreted as the one able to accomplish goals. It is also defined as the capacity to act or the strength & potency to accomplish something. We have the access & control over resources which our clients need.
100
A STRATEGY USED TO PROVIDE CARE TO PATIENTS IN A VARIETY OF SETTINGS
What is NURSING CARE DELIVERY MODEL? The oldest model is the Total Patient Care Nursing Model, also referred to as cases, such as private duty. When we really consider models, we realized many are merely recycled, revamped older models. The choice of a model involves staff skills, availability of resources, patient acuity and the nature of the work.
100
COMPREHENSIVE, INTEGRATED APPROACH TO CARE & REIMBURSEMENT OF HIGH COST, CHRONIC ILLNESS
What is DISEASE MANAGEMENT - POPULATION-BASED HEALTH CARE - CONTINUOUS HEALTH IMPROVEMENT? Goals to address illness of conditions with maximum efficiency across treatment settings regardless of typical reimbursement patterns. Aggregated data will provide framework move to: user satisfaction, quality & affordable. Continuum of care that establishes early detection & early intervention. This prevents or reduces exacerbation or acute episode which is call cost drivers. DM continues to hold significant promise as a strategy for promoting cost effective quality health care in the future & can only expand in scope & practice.
200
UPWARD COMMUNICATION CAN BE LIMITED, HOWEVER AUTHORITY & RESPONSIBILITY ARE CLEARLY DEFINED
What is LINE STRUCTURES? Much like a bureaucracy, relationships are simple & the group is effective, however upward communication is restricted & going outside the chain of command is usually inappropriate
200
THESE 14 FORCES CREATE A TRANSFORMATIONAL STRUCTURE THAT ACHIEVES EMPIRICAL QUALITY RESULTS
What is 14 FORCES OF MAGNETISM OR MAGNET STATUS? Not a prize or reward, a credentialing of nursing excellence. Must reapply every 4 years. Started by American Academy of Nurses in 80's by looking at hospitals that are able to recruit and train the best nurses. They found high performing well qualified nurse executives in a decentralized environment. In 2003 the ANCC established the pathway to excellence program which is based on a survey the nurses complete
200
THE ABILITY TO GRANT FAVORS OR REWARD OTHERS
What is REWARD POWER? This arsenal or rewards can be very broad & this type of leadership develops a great deal of loyalty & devotion
200
CARE "GIVEN THROUGH OTHERS" & BASED ON TASKS
What is FUNCTIONAL METHOD? Began in response to WWII, when there was a nursing shortage & ancillary help was needed. Most hospitals will deny they use functional nursing, however assigning low-skill tasks to unlicensed assistive personnel frees up the nurse to perform more highly skilled duties & is therefore economical.
200
PAYMENT WILL MOVE FROM PRODUCERS TO A PAID SERVICE FOR POPULATION OR EPISODE
What is BUNDLE PAYMENT? Move from volume to value (not how much but how effective) Building sustainable care (did what we did really matter?)
300
THE PRESENCE OF FORMAL VERTICAL & HORIZONTAL CHAIN OF COMMAND REPRESENT BOTH PRODUCT & FUNCTION
What is A MATRIX ORGANIZATION OR STRUCTURE? Function is the task required to produce the product, & the product is the end result. Decision making can be slow.
300
SKILLS AND EXPERTISE ARE POOLED TO SOLVE PROBLEMS OR IMPROVE SERVICES
What is COMMITTEES? It should be free of status & power & instead a shared decision making. They are used to facilitate upward communication & are especially helpful when there is resistance to change.
300
FEAR OR PUNISHMENT WHEN MANAGEMENT'S EXPECTATIONS ARE NOT MET
What is COERCIVE OR PUNISHMENT POWER? This is the opposite of reward power. A manager who ignores or shuns an employee is exercising power through punishment, just as one who belittles or berates an employee
300
UNDER THE DIRECTION OF A NURSE ANCILLARY PERSONNEL PROVIDE CARE TO A GROUP
What is TEAM NURSING? Team nursing allows members to contribute their own special expertise or skills, share the workload, however frequently insufficient time is allowed for team planning & communication. The Future of Nursing a 2010 Institute of Medicine Report wishes to expand the opportunities for nurses to lead & diffuse collaborative improvement efforts with physicians & other members of the healthcare team. This will assure that comprehensive & holistic care can be provided, the team leadership role typically falls on the nurse.
300
-INCREASE NURSE'S UNDERSTANDING OF ALL HEALTH CARE POLICY EFFORTS -PAY ATTENTION TO MENTORING FUTURE LEADERS -PLACE MORE NURSES IN POSITIONS THAT INFLUENCE PUBLIC POLICY -STOP NURSES FROM ACTING LIKE VICTIMS
What is ACTION PLAN FOR INCREASING THE POWER OF THE NURSING PROFESSION?
400
A DECENTRALIZED ORGANIZATION WHERE ONE WOULD HAVE A WIDE SPAN OF CONTROL
What is FLAT ORGANIZATIONAL DESIGNS? In a financial crunch, organizations may eliminate managerial players by cutting positions. This brings more decision making to where the work is being done.
400
A LEADERSHIP STYLE THAT REFLECTS THE TASK/RELATIONSHIP/BEHAVIOR OF THOSE BEING MANAGED
What is SITUATIONAL OR CONTINGENCY LEADERSHIP THEORY?
400
ONE WHICH IS GAINED THROUGH POSITION OR TITLE
What is LEGITIMATE POWER? Power has inherent ability to create feelings of obligation or responsibility. To some degree the socialization & culture of the subordinates will influence how much power a manager has. This differs from expert power, which is gained through knowledge, expertise or experience. This power is limited to a specialized area.
400
24 HOUR RESPONSIBILITY FOR PLANNING CARE FROM ADMISSION TO DISCHARGE
What is RELATIONSHIP BASED NURSING - PRIMARY CARE - MODULAR NURSING? Developed in the late 1960's in an attempt to bring the nurse back to the bedside. It was revolutionary for the first time in hospitals responsibility & authority for specific patients were allocated to a nurse. The other shifts were referred to as the associate nurse.
400
THE ART OF USING LEGITIMATE POWER WISELY
What is POLITICS? It is important for Managers to understand the politics within an organization. The following strategies will help the novice manager negate the negative effects of the ________ if an organization: Become an expert handler of info & communication Be a proactive decision maker Expand personal resources Develop political alliances & coalitions
500
AN ASSESSMENT OF AN ORGANIZATION'S POWER, COMMUNICATION, SAFETY, SUPPORT, & SOCIAL & PHYSICAL ENVIRONMENT
What is ORGANIZATIONAL CULTURE? This is the total organization's language, traditions, customs, & sacred cows.
500
MEMBERS OF THE GROUP FAIL TO TAKE RISKS BY DISAGREEING & "JUST GO ALONG WITH IT"
What is GROUPTHINK? Manager must demonstrate critical thinking & be a role model by having the group challenge their ideas
500
OTHERS IDENTIFY WITH WHAT THIS LEADER SYMBOLIZES
What is REFERENT POWER? Power that a person identifies with. May also occur when one gives another person feelings of person acceptance or approval. It can come from associating with powerful people. Physicians use this power very effectively, society as a whole views them as powerful & they very carefully maintain this image.
500
A COLLABORATIVE PROCESS OF ASSESSMENT, PLANNING, FACILITATION & ADVOCACY
What is CASE MANAGEMENT? Developed to meet an individual's health needs through communication & available resources to promote quality & cost effective outcomes. They are now being seen in out patient settings, but historically their role has been episodic for the treatment of disease for insured individuals. They integrate utilization management & discharge planning, they may be unit based, assigned by patient or disease based.
500
-MAINTAIN PERSONAL ENERGY -DETERMINE THE POWERFUL -LEARN THE ORGANIZATIONAL CULTURE -PRESENT A POWERFUL PERSONA
What is POWER BUILDING STRATEGIES?