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24 Cards in this Set

  • Front
  • Back
Leadership
Personal characteristics or qualities that the leader uses to influence others to achieve an idenified goal.

Key attributes:
Works effectively with members of the group or team.
Facilitates communication among members of the group or team
Motivates the members of the group or team.
Leadership Styles
Autocratic Leadership: uses power to influence group members. The leader makes the decision and gives minimal consideration to the idea or suggestions of member.
Participative leadership: uses the democratic process for decisionmaking with group members. The leader encourages the particpation of members and provides consisent feedback.
Laissez-faire: Uses minimal guidance and provides little feedback to group members. The leader is unwilling to make decisions and consequently does not initate change.
Transactional: focuses on daily activities and is comfortable with status quo. The leader rewards group membersfor work accomplished and deals with problems after they occur.
Transformational: articulates a vision and commitment to the organization's goals. The leader empowers members to achieve the goals and vision.
Team Building
Collaborates to promote the effciency of the organization and to optimize patient outcomes. Develops the highest potential of its membersso that they contribute in significant ways, accept more responsibilty, and share a commitment to the organization goals and structure.
Team
A group of people committed to an identified, shared purpose with common goals, complementary or shared skills, and a similar approach to completing the work.
Successful Team:
ability to self regulate
awareness of team members roles including strenghts and weaknesses
adaptability to changing events
accountability for evaluating action
responsibility for revising the plan as necessary
Traditional Model of Team Effectiveness
Views the team as a series of component that includes team building, team processes, and team effectiveness; examines the symptoms of team effectiveness, but does not look at the actual reasons, such as motivation or cognitive processes, that drive the team toward attainment of its goals.
Assumes teams are passive, stable, and behavioral entity. Team building is geared toward redesigning behavioral processes by examining the signs of team effectiveness, rather than the cause. Team process includes: communication, social intergration, role clarification, and goal setting. Process, attitudiinal, and perceptual indictors measure team effectiveness.
Cognitive Motivitional Model of Team Effectiveness
Based on the premise that each of the variables are interdependent and can be used to evaluate and redesign team developed interventions. Assumes that the team is an active, dynamic, fluid, and cognative motiviation entity; team causes or purposes include shared goals and actions, the ability to evaluate its actions and to redesign its interventions; team processes are self-regulated and have diagnostic perogative. Team effectiveness is measured byt eh achievement of results. Team building focus on redesigning cognitive functioning by analyzing team effectiveness.
Benefits of Team Building in Health Care
Nursing, medicine, and other health care professionals must provide integrated care that supports optimal use of health care resources to improve patient outcomes.

Collaboration among nurses provide continuity of care by focusing on a plan that promotes teamwork to enhance positive patient outcomes and to coordinate care delivery.

Interdisciplinary collaboration involves the joint collaboration of professionals from other disciplines, such as nursing and medicine, working towards the common goals of improving quality of care and outcomes for patients.

Teams can streamline health care services for patients while avoiding duplication or gaps in their care.
Team Building and Teamwork
Clear expectations about the roles, skills and goals of the team and its members enhance teamwork, reduce conflict, and promote success.

Participative learning experience foster collaboration among the members of the team.

Effective communication among team members promote team effectiveness.

Support, encouragement, respect, and commitment, among members facilitate teamwork.

Recognition of one member of the team as the leader by other members enhances group processes.
Barriers to Team Building and Team Work
Health care professionals have not been taught about teamwork or team building.

Sex roles sterotyping and gender hierachy have a negative effect on interdisciplinary groups.

Role status of team members has the potential to impede communication within the group.

Team members with traditional views of organizational roles may have difficulty with team work.

Situations that promote lack of communication, support, and respect for team members impair teamwork.
Case Management Society of America definition of Case Management
A collective process which assesses, plans, implements, coordinates, monitors, and evaluates the options and services required to meet an individual's health needs using optionsand services required to meet an individual's health needs using communication and available resources to promote quality, cost-effective outcomes.
American Nurses Credentialing Center definition of Case Management
Dynamic and systematic collaborative approach to providing and coordinating health care services to a defined population. It is a participative process to identify and facilitate options and services for meeting individuals health needs, while decreasing fragmentation and duplication of care and enhancing quality, cost-effective clinical outcomes.
Acute Care Setting and Case Management Models
Nurse care managers coordinate each patient's care throughout hospitalizations as the patient moves to different locations throughout the institutions

Plans use diagnostic related grouping (DRG) length of stay, clinical pathways reports, and variance analysis, along with interdisciplinary collaborative group practice arrangement, to provide health care services to these patients.
Community-based Setting and Case Management Models
Coordinate the care of patients from the hospital to the community or longterm care setting, if indicated. These patients have chronic health conditions and need long term health care services. These patients have long term health conditions and need long term health care services. Provides care to high risk patients across the continuum of care.
Case Management and Variety of Community Settings
Long term health care
Rehabilitation case management
Occupational health care
Insurance case management
Managed care and health maintenance.
Role of Case Management
Establish a professional case management relationship with the patient and family.

Assist the patient and family in adapting to teh health problems.

Adocate for the patient and family.

Ensure that the patient and family education needs associated with health problems are met.

Manage, coordinate, and facilitate the health care services that the patientand family needs.

Make sure that health care services are appropriate, delivered within the required time frames, and coordinate across the continuum of care.

Evaluate the quality and cost-effectiveness of health care services delivered to patients and their families.
Total Quality Management
A way to run complex organizatons to achieve the aims or missions of the organization.
Emphasizes empowerment of employees.
Recognizes that an organization or department has multiple customers who may have competing needs.
Quality problems occur when good people get caught in broken processes or systems that don't work.
A key strategy of TQM is to involve the worker in improving the work processes through continuous quality improvement.
Continuous Quality Improvement
An approach to improve quality that focuses on how the work gets done rather than on who is doing the work.

A process is a sequence of action leading to an outcome that is important to customers who depend on the process.
It often happens with complex processes that no one individual or department understands the whole process. Requires an interdepartmental team.

Empowers health care workers to reduce the cost and improve the quality of their work.
Shewart Cycle (Deming Cycle)
Planning and improvement process most commonly used in US health care organizations today

Plan -> Do -> Check -> Act -> Repeat
Continuous Quality Improvement relies on Data
Quality issues are identified from data.
Local and national data are used to establish benchmarks for quality care.
Data is collected and analysed to determine the effect of the change on the process of care.
Barriers for CQI programs
Organizational barriers: resistance to change,
behavioral change is in conflict with the organization's philosophy, ltimited time, lack of organizational support

Management barriers: not accepting role change associated with CQI, lack of managerial support, organization's goals not clearly communicated to management.

Process barriers: data are not available, national or local benchmarks have not been defined.

CQI team barriers: Key departments not represented, lack of understanding by team members, personal agendas
Outcome Evaluation
A change in status between two points in time; change may be positive or negative.
Outcome Evaluation and Patient Outcome
Morbidity or incidence of complications
Mortality
Hemodynamic parameter
Laboratory values
Symptoms
Functional status
Outcome Evaluation and Health Care Provider
Change in knowledge or skilled level.
Compliance with practice standards
Outcome Evaluation and System Outcomes
Services utilization
Length of hospital stay or duration of services.
Cost of care or services