As you strive to grow in your leadership skills and abilities, you will find that the context in which you work influences your motivation and areas of focus. In a similar vein, your commitment to developing professionally can contribute toward organizational effectiveness.

To that end, it is critical to recognize the importance of organizational culture and climate. In particular, through this week’s Learning Resources, you may consider several questions: How do an organization’s mission, vision, and values relate to its culture? What is the difference between culture and climate? Moreover, how are culture and climate manifested within the organization?

For this Discussion, you explore the culture and climate of your current organization or one with which you are familiar. You also consider decisions and day-to-day practices and the way they relate to the organization’s mission, vision, and values.

To prepare:

• Review the information related to planning and decision making in health care organizations presented in the textbook, Leadership Roles and Management Functions in Nursing: Theory and Application. Consider how planning and decision making relate to an organization’s mission, vision, and values, as well as its culture and its climate.
• Familiarize yourself with the mission, vision, and values of your organization or one with which you are familiar. Consider how the statements and actions of leaders and others within the organization support or demonstrate the organizational mission, vision, and values. In addition, note any apparent discrepancies between word and deed. Think about how this translates into expectations for direct service providers. Note any data or artifacts that seem to indicate whether behaviors within the organization are congruent with its mission, vision, and values.
• Begin to examine and reflect on the culture and climate of the organization. How do culture and climate differ?
• Why is it important for you, as a master’s-prepared nurse leader, to be cognizant of these matters?

Post  (1) a description of your selected organization’s mission, vision, and values. (2) Describe relevant data, or artifacts, words, and actions of leaders and others in the organization that support, or perhaps appear to contradict the organization’s mission, vision, and values statement. (3) In addition, discuss the organization’s culture and its climate, differentiating between the two. (4) Explain why examining these matters is significant to your role as a nurse leader

REQUIRED RESOURCES

Readings

• Marquis, B. L., & Huston, C. J. (2015). Leadership roles and management functions in nursing: Theory and application(8th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.
  • Chapter 1, “Decision Making, Problem Solving, Critical Thinking: Requisites for Successful Leadership and Management, and Clinical Reasoning”
    
    Chapter 1 provides information relevant to this week’s Discussion and serves as a foundation for topics explored in future weeks of the course. The authors note that decision making, problem solving, critical thinking, and critical reasoning are integral to both leadership and management and beneficial as one examines leadership and management issues. As you read this chapter, focus primarily on the “Decision Making in Organizations” section.
  • Chapter 7, “Strategic and Operational Planning”
    
    This chapter introduces planning and highlights some of the trends that are likely to impact health care organizations now and in the future. It also addresses vision and mission statements, which are essential for guiding planning and decision making in health care settings.
  • Chapter 12, “Organizational Structure”
    • “Organizational Culture” (pp. 260–286)
      
      This section of the chapter addresses organizational culture.
• Bellot, J. (2011). Defining and assessing organizational culture. Nursing Forum, 46(1), 29–37.
  Retrieved from the Walden Library databases.
  
  This article examines organizational culture as a construct. It explores how organizational culture is unique to every workplace.
• Business Dictionary.com.(2013) Organizational culture: Definition. Retrieved from http://www.businessdictionary.com/definition/organizational-culture.html
• Collins, J. C., & Porras, J. I. (1996). Building your company’s vision. Harvard Business Review, 74(5), 65–77.
  Retrieved from the Walden Library databases.
  
  This seminal article helped to pave the way for understanding why a company’s vision is so important. By focusing on its vision, a company can guarantee that its core values and purpose remain fixed while its strategies and methods are adapted to accommodate the changing environment.
• Nelson, W. A., & Gardent, P. B. (2011). Organizational values statements. Healthcare Executive, 26(2), 56–59.
  Retrieved from the Walden Library databases.
  
  This article focuses on the impact that organizational values statements have on an organization’s mission. For employees to follow value statements, leaders must effectively model those values day in and day out.
• Plath, D. (2013). Organizational processes supporting evidence-based practice. Administration in Social Work, 37(2), 171-188. doi:10.1080/03643107.2012.672946
  
  Abstract: A case study illustrates the implementation of evidence-based practice (EBP) as an organizational change process. A systemic process, reliant on executive leadership and organizational culture, facilitates implementation of EBP. Qualitative findings suggest that effective EBP implementation requires engagement of staff across the organization. The development of communities of practice and other strategies to engage staff, including a model for organizational analysis, assists preparation for EBP implementation.
• Rai, G. S. (2013). Job satisfaction among long-term care staff: Bureaucracy isn’t always bad. Administration in Social Work, 37(1), 90-99. doi:10.1080/03643107.2012.657750
• Abstract: The study investigated the influence of role conflict, workload, centralization, and formalization on job satisfaction of long-term care staff. Regression analysis revealed that role conflict, workload, centralization, and formalization together contributed 40.0% variance in job satisfaction. Role conflict and workload decrease job satisfaction while centralization and formalization increase it.
• Watkins, M. (2013, May). What is organizational culture? Retrieved from https://hbr.org/2013/05/what-is-organizational-culture
  
  This site offers several descriptions of organizational culture. These perspectives provide the kind of holistic, nuanced view of organizational culture that is needed by leaders in order to truly understand their organizations — and to have any hope of changing them for the better.  

Online Assessments

Note: Results from the following assessment are required for the course.

• Keirsey Temperament Sorter (KTS-II). (n.d.). Retrieved from http://www.keirsey.com/
  
  Please complete the online assessment and receive a free mini report. Additional, more extensive reports are available for purchase and are optional. You should complete the Keirsey Temperament Sorter assessment early in the course so you will be prepared to discuss the results in Week 9.

Media

• Laureate Education, Inc. (Executive Producer). (2012e). Foundations of an organization and organizational assessment. Baltimore, MD: Author.
  
  In this week’s media presentation, experts from a diverse group of health care organizations share insights on how an organization’s mission, vision, and values influence its daily practices.
  
  Please click on the following links for the media transcripts:
  • Program A Transcript (PDF)
  • Program B Transcript (PDF)
  • Program C Transcript (PDF)
  • Program D Transcript (PDF)
  • Program E Transcript (PDF)
  • Program F Transcript (PDF)

• Laureate Education, Inc. (Executive Producer). (2012c). Factors that influence organizational cultures: Coastal Medical Associates, Salisbury, MA. Baltimore, MD: Author.
  
  Note: The approximate length of this media piece is 6 minutes.
  
  This week’s media pieces provide a glimpse into three very different health care organizations. The experts share the mission, vision, and values of their organization and the focus of the organization (teaching, research, patient care) and discuss how this influences the organizational structure.
  
  In addition to watching this media, you are strongly encouraged to view the “Stories from Skid Row” video from Union Rescue Mission, located in this week’s Optional Resources.
• Laureate Education, Inc. (Executive Producer). (2012d). Factors that influence organizational cultures: Huntington Hospital, Pasadena, CA. Baltimore, MD: Author.
  
  Note: The approximate length of this media piece is 4 minutes.

Optional Resources

You may find the following online assessments useful as you proceed through the course:

Appraisal 360. (n.d.). Retrieved from http://www.appraisal360.co.uk/

HumanMetrics. (n.d.). Jung Typology Test. Retrieved from http://www.humanmetrics.com/cgi-win/jtypes2.asp

Leadership-Tools.com. (2012). 360 degree feedback leadership tool. Retrieved from http://www.leadership-tools.com/360-degree-feedback-leadership.html

Union Rescue Mission. (Executive Producer). (2012). Stories from Skid Row [Video file]. Retrieved from http://urm.org/solution/stories-from-skid-row/

Choose two issues or challenges that the leaders of today’s health care organizations face. Select from among the following topics:

1.Staff Shortage (Physicians, Nurses, Allied Health Providers, Ancillary Services)

2.Reorganization in Response to Merger or Consolidation of Services

3.Layoffs as a Result of Declining Revenues

4.Influx of Registry, Part-Time, and Temporary Contract Staff

5.Poor Performance Outcomes Leading to a Reduction in Medicare Reimbursement Dollars

6.Poor Job Satisfaction Rates Resulting in Turnover

You are the manager of an ancillary service department at a large, 500+ bed hospital. Develop a proposal (750-1,200 words) that is directed toward your staff, in which you address the following:

1.Inform the staff of the two issues (from the topics provided) your organization is facing.

2.Describe the impact of these issues on your department.

3.Describe how improved communication, collaboration, and teamwork can improve conditions in your department.

4.Identify at least two examples from the required or recommended readings of techniques found to foster inclusion and improve communication and collaboration.

5.A minimum of three academic references from credible sources are required for this assignment.

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.

Middleville Regional Health Care is one (1) of three (3) hospitals serving a community of 350,000 people. Summary statistics on Middleville and its competitors, from the AHA Guide, are shown below in Table 1. All three organizations are not-for-profit.

Table 1: Middleville, Brierfield, and Greystone Health Care Systems

Name	Beds	Admissions	Census	OP Visits	Births	Expenses (000)	Personnel
Middleville	575	13,000	350	221,000	2,300	$125,000	2,000
Brierfield	380	17,000	260	175,000	1,200	$130,000	1,875
Greystone	350	10,000	180	40,000	900	$80,000	1,200

The governing board of Middleville hired a consulting company to evaluate its strategic performance, specifically in the areas of Human Resources, Information Technology, Financing, and Marketing. As part of the consultant’s evaluation, several leaders of Middleville’s units were asked their perspective of the organization’s performance.

You are working for the consultant. Your job is to identify the issues from the response that should be considered further by the consultant team and possibly discussed with the governing board and the CEO. The firm has a rule, “Never offer a criticism or negative finding without suggesting how the client organization can correct it,” so you must indicate what sort of correction you would recommend as part of your list. Because you know there were about two (2) dozen other interviews, you decide you should rank your issues in importance, to make sure the most critical are discussed.

Write a six to eight (6-8) page paper in which you:

1. Explain the governing board’s role in these strategic initiatives, determining its responsibility and involvement.
2. Evidence-based management means that operational and strategic decisions are made based upon the evidence that goals and objectives are actually being met. Quantitative measurements must be identified and measured. This data is then used to evaluate the HCO’s performance. Name three (3) performances Middleville can use to measure its success in providing quality healthcare to the community, and identify quantifiable, measureable indicators that can be used to do so. Explain the importance of each performance measurement.
3. Given the statistics of Middleville and its two (2) competitors provided in Table 1, recommend to the HCO what areas it should focus on to maintain its competitive market share as well as continue to provide healthcare to the community in the 21^st century.
4. Some of Middleville’s Board members are very interested in pursuing advanced technology systems over the next five (5) years, while others are concerned about the enormous expense and need assurance that the investment in technology will be worthwhile. In both monetary and process terms, describe the costs and benefits associated with implementing EMR and associated health data systems. Lay out a plan for how various systems can be implemented.
5. Middleville has faced many challenges in recruiting and retaining nurses and other clinical employees. The economy has hit the area very hard and budgetary limitations have reduced the amount of money available for salary increases. The Board knows it needs to provide other benefits to their valued employees. Provide at least two (2) suggestions to Human Resources to promote employee satisfaction and, therefore, retain experienced personnel.
6. Use at least three (3) quality resources in this assignment. Note: Wikipedia and similar Websites do not qualify as quality resources.
7. Format your assignment according to the following formatting requirements:

<!–[if !supportLists]–>a.     <!–[endif]–>Typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides.

<!–[if !supportLists]–>b.    <!–[endif]–>Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page is not included in the required page length.

<!–[if !supportLists]–>c.     <!–[endif]–>Include a reference page. Citations and references must follow APA format. The reference page is not included in the required page length.

The specific course learning outcomes associated with this assignment are:

• Examine how healthcare management concepts and theories are applied to critical issues in healthcare organizations.
• Analyze the critical management issues, purpose, functions, and performance measures of different departments within healthcare organizations.
• Explain how public policy has shaped the development of the U.S. healthcare system.
• Use technology and information resources to research issues in health services organization management.
• Write clearly and concisely about health services organization management using proper writing mechanics.

Assignment 1 – Using EBP to Formulate a Clinical Question

Purpose:

This Assignment is helpful in developing the groundwork for understanding and integrating evidence-based practice in healthcare throughout the rest of the course. In this Assignment you will have the chance to see how the research you look for can be applied in the work you do in your practice.

Overview:

You will select a topic relevant to your practice area, post the topic to Discussion Board 2 for feedback, research the topic, and write a scholarly paper. My Topic is “The Benefits of a Kidney Transplant versus Dialyis”

From the chapter readings and discussion, formulate a 3–5 page scholarly paper in APA format, providing an overview of the terms and function of EPB. An introduction, discussion and conclusion is expected in the overview on this topic

Directions:

1. Formulate the question.
2. Using the Cochrane database, research the question using the PICOT model and key words.
3. Post your topic and a short summary of results for feedback from your instructor and peers by Day 5.
4. Write a 3–5 page paper, reviewing evidence-based practice, as it relates to your practice question and integrate feedback from the instructor and/or peers.
5. Include a minimum of three evidence-based references.