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122 Cards in this Set
- Front
- Back
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define leadership
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act of guiding
influence people achieve outcomes beliefs outcomes behaviors |
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define management
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coordinate resources
materials people time involves PROBLEM SOLVING DECISION MAKING |
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Do leaders delegate authority?
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NO managers do this.
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What is Leadership Trait THeory?
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intellegence alertness dependability energy drive and ambition
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interactional leader
transactional leader trasnformational |
variables - culutre values influence situation work environment
main concern is day 2 day operations commits to organizational goal vision people |
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Which type of leadership is effective for productivity and short term tasks?
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transactional
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What is the goal of transformational leadership?
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to TRANSFORM duhh
followers into leaders through... MOTIVATION rather than REWARD |
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The key element to transformational
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Vision
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4 things transformational leaders do?
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1. identify and communicate vision & direction
2. Empower the work so the group accomplishes goals and objectives 3. Provide mentoring 4. are role models and admired! |
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4 things transaction leaders do
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1. focus on day 2 day
2. rewards staff for desired work 3. monitor performance and correct as needed 4. reactionary - waits until problems occur before dealing with a situation |
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Management theory stems from what theory?
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BEHAVIORAL THEORIES
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Characteristics of Authoritarian
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controlling
coercive commanding independent decision makers |
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Char of Democratic
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rewards
guides gives constructive criticsm involves others in decision making |
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Char of Laissez faire
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permissive
no control supports when requested no direction no feedback/critism. |
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5 qualities of a change agent?
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1. management leadership skills
2. understands change theory and how to use it 3. has pro planning skills 4. good communicator 5. good collaborator |
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Framework for LEADING CHANGE
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manage change x being strategic x engage people = change intiative
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leadership management in our current healthcare climate.. benefits?
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improve work environment = safer care
promote transformational leadership staff development encourages disciplinary collab more skills usage - increase scope of practice maximize worksforce capability |
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in current health care climate, leadership and management concentrate on
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health not just healthcare
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leadership management in our current healthcare climate.. more benefits?
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advocate for community services
move away from acute care focus focus on intersectoral health use appropriate technology |
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QUALITY ASSSURANCE
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Unit or department
level Focus on organization Considers individual performance Often managed by separate department |
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QUALITY IMPROVEMENT
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Broad in scope
Focus is on customers Considers whole system Managed by organizational leadership |
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How can demings recommendations be applied to nursing?
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v
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The JURAN trilogy offers? a framwork for quality
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tools to do work
3 managerial processes - planning control improvement |
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Jurans Quality Planning - 2 aspects of it
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determine customers are and their needs
service features that work to respond to the needs |
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Juran quality control aspects
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evaluate the quality performance
compare it with the goals act on the difference |
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Juran Quality Improvement
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establish infrastructures
identify specific needs for improvement establish project TEAM provide resources and training |
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88% of problems can be resolved by changing the system as said by:
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JURAN 85/15 rule
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name 3 quality improvement tools
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data collection
data analysis Process Description |
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as an individual nurse how do u use the professional standards ?
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advocate for improvements to promote quality care and nursing practice
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2 ways Professional Standards can be used in RESEARCH?
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develop modify and evaluate ::
-quality improvement intiatives -evidenced based decision support tools |
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ADVOCACY
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active support of an important cause,
supporting others to act for themselves or speaking on behalf of those who cannot speak for themselves ” |
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examples of advocacy
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patient
self profession/practice policy/workplace community |
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What is Lobbying?
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persuading elected officials to vote a
certain way on an issue or to carry an issue forward for debate.. ” |
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direct lobbying method
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letters
phonecalls emails meet with stakeholders HOLA!! get unions/organizations to be involved hold rallies PROTEST!! jk... candle light vigil |
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INdirect lobbying method
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books, articles, reports
enlist support of stakeholders get media to help out - TV reporters , newspaper, radio |
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NURSING ACTIVISM
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Any political act that ...influences another
person for the purpose of allocating scarce resources wisely |
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are nurses underutilized by the healthcare system?
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YES
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elements for effective political awareness and political action.
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Understand formal and informal systems in an
organization Strong interpersonal communication skills Collaboration Develop base of support Clear goals and plans |
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3 common principles and goals to advocate for change?
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1.Create public support: Speak from your nursing
experience how directly patients are impacted 2.Unity–Unify nursing at provincial/territorial/national/international levels 3.Collective Action –work with others like the media / professional associations / coalitions |
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What two or three key policy issues should be top priorities for the Association
to address in BC? |
Connecting Policy and Practice
Primary Health Care Recognize the Importance of Collaboration |
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what does CNA do?
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Leadership
• Public Policy • International Policy Development (ICN) • Professional Practice and Regulation – CRNE – Specialty Certification – Code of Ethics • Promoting Quality Practice Environments |
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CNA values are
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Social determinants of health
Primary Health Care Canada Health Act |
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Canada Health Act 5
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Accessability
Portability Universality Comprehesiveness Public Administration |
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The CNA specifically does for the CHA principles
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Service Delivery
• Funding • System Redesign |
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one resource for nursing activists?
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arnbc.ca
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QUality improvement vs Quality assurance
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proactive - ongoing/culture - customers ie. pts/client
reactive - meeting targets - more on organization |
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Benchmarketing
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standard/baseline/stock
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Risk Management
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reducing liability
for example: all factors to reduce medication errors for example: PPE precautions |
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Indicators are
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units of measurement to meet the goal
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Variation is
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variables that influence the results
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Demings framework is used for many organizations. it is focused on
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effective teamwork
leadership culture for change resources toward education research always evaluate change - quality control |
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Jurans Tool for change example in real life today
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changing the systems : emergency flow of patients waiting. increases satisfaction for all
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How does health informatics help canadians?
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Health informatics enables and supports all
aspects of safe, efficient and effective health services for all Canadians |
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What is Telehealth?
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Service delivery provided at a distance using
electronic technology |
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Pros of Healthcare informatics ?
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Multidisciplinary
• More efficient charting • Increased consistency in care • Improves ability for data collection for research • Increased access to information and services for clients • Improved coordination of care • Decreased duplication • Faster and more accurate than humans! (sometimes) |
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Challenges of tele-health/health informatics
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connection at the bedside-humanistic value lost?
Confidentiality, privacy Hacking Client fear / panic selfdiagnosing (labs) Need for computer literacy-both HCP and pt System malfunctions or shut-downs Cost of technology versus value to client/ quality of care (return oninvestment) System maintenanceEfficiency–ptcare replaced with technical tasks and a focus on outcomes Ethical issues–develop SOPs, policies, decision- making protocols |
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1. What are the primary roles and responsibilities of the Canadian federal government in regards to the national health care system?
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1. Setting and administering national principles for health care system through CHA
2. Delivering health care to specific groups (1st nations, inuit) 3. Financial support to provinces/territories |
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What is the role of the provincial and territorial governments in terms of the health system?
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1. Deliver services
2. Fund services with assistance from the federal cash and tax trfs 3. Determine what is considered “medically nesc” as per CHA 4. Plan and fund hospital care 5. Health promotion and public health initiatives 6. Negotiate fee schedules |
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What is health canada's responsibility?
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helping the people of Canada maintain and improve their health
to making this country's population among the healthiest in the world Encourages Canadians to take an active role in their health, such as increasing their level of physical activity and eating well. |
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What does health canada rely on to promote better health?
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Relies on high-quality scientific research
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3. The federal Minister of Health is
our provincial counter-part is |
Leona Aglukkaq
Hon. Margaret MacDiarmid |
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Nursing Directorate in BC
what is the primary function of that department? |
Grants funds to individuals and organizations (e.g. health authorities, educational institutions, aboriginal groups, and regulatory bodies) to carry out specific nursing related projects and initiatives; the development, implementation and evaluation of nursing programs, priorities, policies and strategies, and management of major projects and initiatives such as NP category of practice in BC
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5. Which agency would be responsible for coordinating a response to an influenza pandemic or an outbreak similar to SARS?
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BC Ministry develops and coordinates plans under Emergency Program Act
Pandemic communications in BC – section II PECC – provincial emergency coordination centre (staffing provided by Ministry of Health) PREOC – provincial regional emergency operations centre (health authorities and BC ambulance provide staffing). Also a mandate of PHAC: Prepare for and respond to public health emergencies |
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Who helps the First Nation Community and provides health services to them?
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Federal – First Nations/Inuit & Aboriginal Health branch – Health Canada
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7. The local health authorities each have a Board of Directors. What is the role of the Board, and how does it differ from the senior management (executive) team for the health authority? How are they selected?
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Working with the executive team, the board establishes VIHA's Vision, Purpose and Values and ensures patients receive the best care possible within an affordable, sustainable health care system.
Board appointments for the Vancouver Island Health Authority (VIHA) are decided by the Government of British Columbia. Members are chosen for their leadership skills, decision-making abilities and willingness to be accountable. |
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8. Are there any sources of funding available through any of the levels of the health system that might help initiate a change within the system?
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Canadian Institutes of Health Research
Federal – First Nations/Inuit & Aboriginal Health branch – Health Canada Public Health Agency of Canada Vancouver Coastal Health Research Institute Local banks – Royal Bank, Vancity Companies – Bell, Telus, Walmart Local radio stations VSB BC Housing |
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1. What are the three primary functions of the BCPSQC?
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a. Advises the Minister of Health services on matters related to health care quality and patient safety
b. Develop tools and support initiatives that will assist health service delivery organizations to make improvements to the quality and safety of care they provide and work to increase opportunities for educational and professional development of health professionals c. Serves the public by acting as a proponent of health system transparency and accountability |
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a. Describe what you think are the key differences between activities, indicators, and targets.
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i. Activity: event
ii. Indicator: how event is measured iii. Targets: specific standards and where and when the data can be found |
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b. Why do you think that these components are outlined in this document in relation to the organization’s goals?
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i. These are outlined because it the goal is the identified activity, the indicator is how the goal or activity will be measured and the target is the standard that each of the goals meet.
ii. These are included in the goals because it provide accountability and transparency based on the councils 3 purposes as indicated above. |
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What is strategic planning?
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provide direction for change, identify response strategies and prioritizes resource allocation
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What are the factors that contribute to successful policy initiatives?
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realistic time commitment, high quality evidence, politcal backing , clear focus, timing
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What is a Vision statement?
What is Mission statement What is Philosophy? What is Value? |
Vision - clear picture of what the future will look like for that organization
Mission - formal expression of the purpose or reason for existence of the organization Philosophy - embedded in the mission statement . essence, value statement of the principles and beliefs that direct the organizations behavior Values - describes the boundaries the organization will have while purusing its vision |
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What can you do at Provincial level to make change?
Federal level? International level? Territorial level? |
i. Enlist support from the CRNBC, ARNBC, and BCNU
i. Enlist support from CNA and other professional associations such as RNAO i. Enlist support from countries with similar projects iv. Enlist support from community health care nurses familiar with the population we are working with |
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Environmental Assessment
SWOT analysis |
broad view of organizations current environment
strengths weakness, opportunities, and threats Internal = strengths, weak External - opportunities, threats |
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Ways to assess stakeholders
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survey, questionnair, focus group interviews, advisory panel
review literatures |
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steps in strategic planning
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perform enviromental assessment
cnduct stakholder analysis review literature determine congruence with mission identify planning goals and objectives estimate resources required for the plan prioritize according to available resources |
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Types of organizational structures
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matrix
flat/tall centralized |
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What is policy?
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value based goal oriented statement dealing with a particular problem or opportunity
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What is a population health framework?
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a policy instrument recommended as a basis for sustainable HCR
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What is Health Policy?
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aspect of public policy
aim to enhance health for public |
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What is about power to influence change in our society and involves conidtions helps impedes policies?
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Politics
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Policy vs. POlitics
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POLICY - proative , values, goals, principles, shoulds oughts, developed through a process, use of research reports
POLITICS - reactive, focus on conidtions, uses power, philosophical foundation, developed through political process, shapes content for policy and policy process |
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What is the nursing role in policy process?
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advisors
and advocates |
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Give 3 strategies for being involved in influencing the policy process?
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involve stakeholders
speak from your experience as a nurse use media create public support vote for policymakers who support humanistic policies be familiar with the issue participate in the planning process |
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first 4 steps in policy cycle
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values beliefs
problem issue knowledge research dvelopement public awareness |
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last four steps in policy cycle
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political engagement
interest group activation public policy deliberation and adoption regulation expreience and revision |
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Identify and explain key components of effective research policy linkages for healthcare reform
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1. interface between the dual processes of research and policy development
2. sensitivity to both context- government health 3. appreciate diverse values all stakeholders 4. astute use of the research outputs 5. role of mediators : brokers "reserach policy" |
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Why is there a nursing shortage?
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new unregulated workers and new technology increases demand
massive job cut in 1990s aging workforce too many challenges in healthcare systm - society, demographics. |
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What are some strategies to healthcare reform that nurses can do?
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realistic time commitment
high quality evidence political backing/network allies clear focus timing - look for policy opportunities to advance issues |
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3 things to assess in population health?
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income
social support disease pattern |
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What is CPHI?
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canadian population health initiative
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What is the result of CPHI?
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health information roadmap intiative.
generates knoweldge of DoH national population health info system sysnthesis of research and analysis of policy options report the health status of canadians |
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Nursing Education Challenges
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positive negative experiences
impact of BSN as entry to practice on the image of the profession Impact of graduate education on the image and advancement of the profession |
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Graduate nursing education provides
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specialized body of knowledge
EIP leadership in health care reform |
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change vs. transition
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change is situational and focuses on a goal
transition is psychological and a process |
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active vs. reactive change
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awareness of change
act based on reflex, no coice to change |
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Chaos theory is
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really about finding the underlying order in apparently random data. BUTTERFLY EFFECT
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Give some barriers to change
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negative experience to previous change
bad attitude no support in the system no resources |
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90% of the effort is spent
talking about change or convincing people to change, and only 10% is devoted to actually working on the change” true or false? |
this is true
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explain unfreezing stage of lewins change theory
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Gather information
Identify problem Decide if change is needed Consider all factors related to change Communicate awareness Identify who will be affected |
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explain movement stage of lewins change
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Accept and Engage in Change
Develop plan and set goals Set goals and objectives Identify areas of support and resistance (identify sources of power) Identify tasks and timelines Develop strategies Implement the change Evaluate change |
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Integration of New Change
Ongoing assessment/evaluation of change Support others in the change Stabilize change and make part of new norm... occurs in which stage in lewins? |
Refreezing stage
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The Model of Improvement steps
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Thinking part then doing part
PLAN DO STUDY ACT |
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the voice at the international level
representing the nursing profession in Canada and advocating for the advancement of the practice of nursing. |
CNA
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In 2010,????? withdrew membership from CNA
and the ARNBC was developed. Membership to CNA is voluntary via ARNBC |
CRNBC
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equipped to engage in lobbying and
activism on behalf of BC nurses which became difficult for CNA to do without conflicting with their mandate. |
ARNBC
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What does CNA do?
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Leadership
Public policy development International policy (partner with ICN) Professional practice and regulation (CRNE, spec. cert, Code of Ethics) Promoting quality practice environments |
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purpose of an organizational structure
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defines formation
shows lines of communication and authority who has decision making power |
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What is shared governance?
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organizational structure
potentially bridges differences of traditional bureaucratic models integrates core values & beliefs of professional practice No specific organizational chart!!!!! |
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Benefits of shared governance
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Increased satisfaction
Increased productivity Improved work environment |
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Organizational beliefs
2. History 3. Taboos 4. Formal and informal relationships 5. Communication patterns |
Organizational CULTURE
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What is the aim of the CHA
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ensure that all residents of candada have access to medically necessary healthcare on a prepaid basis
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What year was CHA created?
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1984
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What does the Federal goverment do for healthcare?
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set/admin policy
principle standards health protetcion/promotion/ disease prevention Funding Veterans first nations, military, RCMP, prison |
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Father of healthcare reform?
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Tommy Douglas
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Provincial level what do they do ?
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admin and deliver healthcare services
place hospitals put number of workers (doctor nurses) budget expenses in the healthcare system |
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MSP includes
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Medical Service Plan
maternity care eye exam Diagnostics Dental |
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What does public administration do?
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ensure compliance
provide report on insured services to fed gov report to parliament admin and operations |
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Chain of Command is
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formal paths of communication and authority
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Top Level
Middle Level First Level managers |
CEO /CHief
Head Nurse Team Leader/Primary Care Nurse, Case Manager, RN. |
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What is Centrality?
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the location of a position on the organizational chart where frequent and various types of communication occur.
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Oragnizational chart examples
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line structures
Ad hoc - use project team or task approach disbands once project is completed Matrix - Spider web - more cross communication occurs |
