For this assignment, using the work issue you identified in Unit 2 (Parted boundaries between medical nurse administrators and senior nurses have blurred, and this has prompted a loss in clear nursing authority), you will:
- Choose an analysis model that is appropriate to your selected issue.
- Identify and describe the model you will be using, then use the model to analyze your work issue. Be sure to address the issue from a nurse leadership perspective.
- Choose one additional model and briefly describe that model.
- Suggest six interventions that would be useful for the nurse leader when dealing with a variety of work issues. For each intervention, you should provide the expected outcome. HEALTH ASSIGNMENT
Writing Requirements
BOOK :
Essentials of nursing leadership and management, third edition, patricia Kelly, Cengage Learning, Clifton Park, NY, 2014 (ch 11)
PART OF WHAT YOU NEED TO TAKE FROM THE BOOK AS THIS COMES DIRECTLY OUT OF THE BOOK (+2 OTHER SOURCES): HEALTH ASSIGNMENT
The 2004 Institute of Medicine (IOM) report Keeping Patients Safe: Transforming the Work Environment of Nurses found that nurses, who comprise the largest segment of the health care workforce and spend the most time providing direct care to patients, are indispensable to patient safety and quality (Khoury, Blizzard, Moore, & Hassmiller, 2011). An earlier IOM report, To Err Is Human: Building a Safer Health System (1999), stated that preventable adverse events cause between 44,000 and 98,000 deaths each year, at an annual cost of between $37.6 billion and $50 billion. These IOM reports have changed the way we view quality and patient safety. It is now generally understood that patient safety is dependent on the implementation of inter-professional collaborative teams and patient care delivery systems that address the realities of practice and patient care. These patient care delivery systems often have errors occur in them. Errors often occur as a result of system failure rather than human failure. Recent research studies stress that the way a nurse’s work is organized is a major determinant of patient welfare. Consequently, nurses must be prepared to be able to implement sound models for the effective delivery of patient care.
Current nursing leadership must embrace future leaders of the nursing profession to mentor and educate these novices. This will help these future leaders acquire the understanding, knowledge, and skill to improve health care. Providing safe, quality health care requires technical expertise, the ability to think critically, experience, and clinical judgment. A high-performance expectation of nurses is dependent upon nurses’ continual learning, professional accountability, independent and interdependent decision-making, and creative problem-solving abilities (Benner, Hughes, & Sutphen, 2008). HEALTH ASSIGNMENT
This chapter discusses the importance of an organization’s philosophy and mission and the steps in the strategic-planning process. It notes the importance of aligning the organization’s strategic plan both with its philosophy, values, and mission, and with the goals and values of the communities and stakeholders served by the organization. The chapter reviews common organizational work structures and work processes used to meet desired organizational outcomes. It discusses high-reliability organizations, a culture of safety, the 14 Forces of Magnetism, the Magnet Model, and the historical evolution and significance of magnet hospitals.
STRATEGIC PLANNING
The purpose of strategic planning is twofold. First, it is important that everyone have the same plan for where the organization is headed, and second, a good plan can help to ensure that the needed resources and budget are available to carry out the initiatives that have been identified as important to the organization. A clear plan allows the nurse manager to select from among seemingly equal alternatives based on the alternatives’ potential to move the organization toward the desired end goal. As Lewis Carroll observed in Alice’s Adventures in Wonderland, “If you don’t know where you are going, any road will do.” A health care organization needs to have a good idea of where it fits into its environment and what types of programs and services are needed and demanded by its customers or stakeholders. This is true at the organization’s board level as well as at the patient care unit level. It is important that a nurse manager have an understanding of which programs and services are valued by a patient population. The nurse manager can then help plan for how the patient care unit’s ongoing activities can serve that population and fit in with the overall strategy of the larger organization. As outlined in Figure 11-1, strategic planning starts with: clarifying the organization’s philosophy and values or what is important to the organization; identifying the mission of why the organization exists; articulating a vision and goals for what the organization wants to be; conducting an environmental assessment, or SWOT assessment, which examines the Strengths, Weaknesses, Opportunities, and Threats of the organization. The SWOT assessment is useful both for initial brainstorming and for more formal planning (Figure 11-2). This information provides data that then drive the development of three- to five-year strategic plans for the organization. Tactics are then created and prioritized. Finally, goals and objectives are concretized into annual, operating work plans for the organization, which can be measured. This same process is used for unit or departmental strategic planning. In developing a strategic plan, unit staff must also examine their organization’s mission, vision, goals, and annual operating plans. Unit strategic plans should be congruent with and support the mission and vision of the organizational system of which they are a part. Therefore, communication with the nursing leadership responsible for the unit and the nursing staff is essential to achieve success. HEALTH ASSIGNMENT
Community and Stakeholder Assessment
A frequently overlooked but highly important area for analysis is the stakeholder assessment. A stakeholder is any person, group, or organization that has a vested interest in the program or project under review. Stakeholders in health care include people such as patients, nursing and medical practitioners, community representatives, insurance companies, hospital/agency administrators, federal and state accreditation agencies, pharmaceutical companies, and technology and equipment companies. A stakeholder assessment is a systematic consideration of all potential stakeholders to ensure that the needs of each of these stakeholders are incorporated in the planning phase of a program, project, or quality initiative. For a program to be successful, engaging and involving all stakeholders is essential. This is true whether the stakeholders are in the community or they are the unit staff who will be affected by a proposed strategic plan. This fact has been reported by Hughes, who identifies the need to “engage all the right stakeholders (ranging from senior management to staff).” Hughes further states that there is a need for staff “to be involved and supported to actively make the change and to be the champion and problem solver within departments for the interventions to succeed” (Hughes, p 101 2008).
An environmental assessment (SWOT analysis) of the type of undergraduate nursing education that would be needed for the 21st-century professional nurse led one school of nursing to begin planning a curriculum revision that would incorporate the increasing emphasis on community-focused care. This assessment of the environment led faculty to understand that new models for clinical education will be needed to promote improved and expanded linkages between education and practice. It is important that the internal environment as well as the external environment be carefully assessed. Whereas the external environmental assessment is broad based and attempts to view
An environmental assessment (SWOT analysis) of the type of undergraduate nursing education that would be needed for the 21st-century professional nurse led one school of nursing to begin planning a curriculum revision that would incorporate the increasing emphasis on community-focused care. This assessment of the environment led faculty to understand that new models for clinical education will be needed to promote improved and expanded linkages between education and practice. It is important that the internal environment as well as the external environment be carefully assessed. Whereas the external environmental assessment is broad based and attempts to view opportunities and threats that could impact the organization, the internal assessment seeks to inventory the organization’s strengths and weaknesses. HEALTH ASSIGNMENT
Additional Methods of Strategic Planning Assessment
A number of other strategic-planning assessment methods can be used in the strategic-planning process. These methods include surveys and questionnaires, focus groups and interviews, use of advisory boards, review of literature on similar programs, and review of best practices. Frequently, surveys or questionnaires are used when there is a large number of stakeholders in order to get a general idea of the options available. For example, staff might be polled to see whether they would attend a continuing education program and which days and times would be most desirable. Focus groups are small groups of individuals selected because of a common characteristic who meet in a group and respond to questions about a topic in which they have interest or expertise, for example, patients with a recent diagnosis of diabetes. These patients might be asked to come together to discuss their diabetes experiences at an institution in the hope that the discussion will lead to insights or information that could be used by the institution for improving diabetic care or marketing diabetic services in the future. Focus groups are usually more time consuming and expensive to conduct than surveys or questionnaires. Focus groups work best when the topic is broad and the options are not clear.
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Additional Methods of Strategic Planning Assessment
A number of other strategic-planning assessment methods can be used in the strategic-planning process. These methods include surveys and questionnaires, focus groups and interviews, use of advisory boards, review of literature on similar programs, and review of best practices. Frequently, surveys or questionnaires are used when there is a largenumber of stakeholders in order to get a general idea of the options available. For example, staff might be polled to see whether they would attend a continuing education program and which days and times would be most desirable. Focus groups are small groups of individuals selected because of a common characteristic who meet in a group and respond to questions about a topic in which they have interest or expertise, for example, patients with a recent diagnosis of diabetes. These patients might be asked to come together to discuss their diabetes experiences at an institution in the hope that the discussion will lead to insights or information that could be used by the institution for improving diabetic care or marketing diabetic services in the future. Focus groups are usually more time consuming and expensive to conduct than surveys or questionnaires. Focus groups work best when the topic is broad and the options are not clear. Large projects often benefit from the formation of an advisory board selected from various stakeholders affected by a proposed program. The advisory board does not have formal authority over the proposed program but does make recommendations and suggestions. Because the advisory board is deliberately selected to reflect representation from various stakeholders and areas of expertise, it is expected that the advisory board
will be able to identify potential concerns and provide sound guidance for the proposed program. A review of literature on similar programs should be completed as part of strategic planning for any new program. This review of literature allows the project team to identify similar programs, their structures and organization, potential problems, pitfalls, and successes. The review of literature is an ongoing process that includes identifying programs, searching the literature for successes and issues, and then refining the program ideas. Identifying best practices or evidence-based innovations that have been adopted with success by other organizations can facilitate strategic planning. Consequently, nurses planning to develop a new program need to carefully examine the existing evidence and best practices prior to beginning strategic planning. HEALTH ASSIGNMENT
