Students in this course prepare to exercise leadership through which they can help to ensure their organization is able to adapt and flourish in the ever-changing world of healthcare. Students explore the impact of healthcare system changes on transforming the nursing profession. They examine and discuss theories related to leadership and management and learn about empowerment strategies that assist master’s-prepared nurses to assume and succeed in leadership roles. Students engage in course assignments that focus on real-world nursing practice applications of theory.
Module 1: Healthcare Environment (Weeks 1-2)
Laureate Education (Producer). (2018). The Healthcare Environment [Video file]. Baltimore, MD: Author.
Learning Objectives
Students will:
- Analyze current national healthcare issues/stressors
- Analyze the impact of national healthcare issues/stressors on healthcare organizations
- Analyze strategies for addressing national healthcare issues/stressors
| Due By | Assignment |
| Week 1, Days 1–2 | Read the Learning Resources. Compose your initial Discussion post. |
| Week 1, Day 3 | Post your initial Discussion post. Begin to compose your Assignment. |
| Week 1, Days 4-5 | Review peer Discussion posts. Compose your peer Discussion responses. Continue to compose your Assignment. |
| Week 1, Day 6 | Post two peer Discussion responses. |
| Week 2, Days 1–6 | Continue to compose your Assignment. |
| Week 2, Day 7 | Deadline to submit your Assignment. |
Photo Credit: [Anuska Sampedro]/[Moment]/Getty Images
Learning Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
Marshall, E., & Broome, M. (2017). Transformational leadership in nursing: From expert clinician to influential leader (2nd ed.). New York, NY: Springer.
- Chapter 2, “Understanding Contexts for Transformational Leadership: Complexity, Change, and Strategic Planning” (pp. 37–62)
- Chapter 3, “Current Challenges in Complex Health Care Organizations: The Triple Aim” (pp. 63–86)
Read any TWO of the following (plus TWO additional readings on your selected issue):
Auerbach, D. I., Staiger, D. O., & Buerhaus, P. I. (2018). Growing ranks of advanced practice clinicians—Implications for the physician workforce. New England Journal of Medicine, 378(25), 2358–2360. doi:10.1056/NEJMp1801869
Note: You will access this article from the Walden Library databases.
Gerardi, T., Farmer, P., & Hoffman, B. (2018). Moving closer to the 2020 BSN-prepared workforce goal. American Journal of Nursing, 118(2), 43–45. doi:10.1097/01.NAJ.0000530244.15217.aa
Note: You will access this article from the Walden Library databases.
Jacobs, B., McGovern, J., Heinmiller, J., & Drenkard, K. (2018). Engaging employees in well-being: Moving from the Triple Aim to the Quadruple Aim. Nursing Administration Quarterly, 42(3), 231–245. doi:10.1097/NAQ.0000000000000303
Note: You will access this article from the Walden Library databases.
Norful, A. A., de Jacq, K., Carlino, R., & Poghosyan, L. (2018). Nurse practitioner–physician comanagement: A theoretical model to alleviate primary care strain. Annals of Family Medicine, 16(3), 250–256. doi:10.1370/afm.2230
Note: You will access this article from the Walden Library databases.
Palumbo, M., Rambur, B., & Hart, V. (2017). Is health care payment reform impacting nurses’ work settings, roles, and education preparation? Journal of Professional Nursing, 33(6), 400–404. doi:10.1016/j.profnurs.2016.11.005
Note: You will access this article from the Walden Library databases.
Park, B., Gold, S. B., Bazemore, A., & Liaw, W. (2018). How evolving United States payment models influence primary care and its impact on the Quadruple Aim. Journal of the American Board of Family Medicine, 31(4), 588–604. doi:10.3122/jabfm.2018.04.170388
Note: You will access this article from the Walden Library databases.
Poghosyan, L., Norful, A., & Laugesen, M. (2018). Removing restrictions on nurse practitioners’ scope of practice in New York state: Physicians’ and nurse practitioners’ perspectives. Journal of the American Association of Nurse Practitioners, 30(6), 354–360. doi:10.1097/JXX.0000000000000040
Note: You will access this article from the Walden Library databases.
Ricketts, T., & Fraher, E. (2013). Reconfiguring health workforce policy so that education, training, and actual delivery of care are closely connected. Health Affairs, 32(11), 1874–1880. doi:10.1377/hlthaff.2013.0531
Note: You will access this article from the Walden Library databases.
Required Media
Laureate Education (Producer). (2015). Leading in Healthcare Organizations of the Future [Video file]. Baltimore, MD: Author.
Discussion: Review of Current Healthcare Issues
If you were to ask 10 people what they believe to be the most significant issue facing healthcare today, you might get 10 different answers. Escalating costs? Regulation? Technology disruption?
These and many other topics are worthy of discussion. Not surprisingly, much has been said in the research, within the profession, and in the news about these topics. Whether they are issues of finance, quality, workload, or outcomes, there is no shortage of changes to be addressed.
In this Discussion, you examine a national healthcare issue and consider how that issue may impact your work setting. You also analyze how your organization has responded to this issue.
To Prepare:
- Review the Resources and select one current national healthcare issue/stressor to focus on.
- Reflect on the current national healthcare issue/stressor you selected and think about how this issue/stressor may be addressed in your work setting.
Sample Paper – Week 1 Discussion 1
NURS 6053 – Review of Current Healthcare Issues
NURS 6053: Discussion 1 Review of Current Healthcare Issues
Student’s Name:
Institutional Affiliation:
Healthcare Challenge
One of the most significant national healthcare issues in the US today is burnout and stress among health care workers. Although health care is an inherently high-stress field due to witnessing patients’ agony and loss of life, there is a worsening rate of stress and burn out. Studies show that nearly half of the US healthcare workers report at least one symptom of burnout, such as emotional and physical exhaustion, low job satisfaction, and depersonalization (Dyrbye, Shanafelt, Sinsky, Cipriano, Bhatt, Ommaya & Meyers, 2017). The healthcare issue may impact the healthcare work setting. It can impair the ability of health workers to connect with patients in meaningful ways and fully concentrate on patient care, resulting in reduced productivity, increased nurse turnover, and risk of suicide among caregivers. This can compromise the quality and safety of care. It can also increase the risk of medical errors and hospital-acquired infections (Jacobs, McGovern, Heinmiller & Drenkard, 2018).
The healthcare challenge can be attributed to various factors. The most significant factor is the rising pressures to produce better outcomes at lower costs in the U.S. health care system. As a result, care providers take the most significant role in implementing the value-based care system. Due to the pressure from the Centre of Medicare Services, healthcare organizations are putting pressure on their employees to change the method of practice. Although the shift is suitable for patients, health workers bear the most significant burden (Park, Gold, Bazemore & Liaw, 2018). In my health system work setting, several initiatives have been implemented to address the issue. Shorter work shifts have been designed to allow health workers time for personal life. Implementing an electronic health record system and employing administrators to handle clerical duties has reduced the care providers’ workload (Shanafelt & Noseworthy, 2017). To improve job satisfaction, participatory decision making where health workers’ views are considered in decision making has been adopted. Additionally, counseling and stress management programs are offered to healthcare workers in the work environment.
References
Dyrbye, L. N., Shanafelt, T. D., Sinsky, C. A., Cipriano, P. F., Bhatt, J., Ommaya, A., … & Meyers, D. (2017). Burnout among health care professionals: a call to explore and address this underrecognized threat to safe, high-quality care. NAM perspectives.
Jacobs, B., McGovern, J., Heinmiller, J., & Drenkard, K. (2018). Engaging employees in well-being: moving from the triple aim to the quadruple aim. Nursing administration quarterly, 42(3), 231-245.
Park, B., Gold, S. B., Bazemore, A., & Liaw, W. (2018). How evolving United States payment models influence primary care and its impact on the quadruple aim. The Journal of the American Board of Family Medicine, 31(4), 588-604.
Shanafelt, T. D., & Noseworthy, J. H. (2017, January). Executive leadership and physician well-being: nine organizational strategies to promote engagement and reduce burnout. In Mayo Clinic Proceedings (Vol. 92, No. 1, pp. 129-146). Elsevier.
By Day 3 of Week 1
Post a description of the national healthcare issue/stressor you selected for analysis, and explain how the healthcare issue/stressor may impact your work setting. Then, describe how your health system work setting has responded to the healthcare issue/stressor, including a description of what changes may have been implemented. Be specific and provide examples.
By Day 6 of Week 1
Respond to at least two of your colleagues on two different days who chose a different national healthcare issue/stressor than you selected. Explain how their chosen national healthcare issue/stressor may also impact your work setting and what (if anything) is being done to address the national healthcare issue/stressor.
Submission and Grading Information
Grading Criteria
To access your rubric:
Week 1 Discussion Rubric
Post by Day 3 and Respond by Day 6 of Week 1
To participate in this Discussion:
Week 1 Discussion
Assignment: Analysis of a Pertinent Healthcare Issue
The Quadruple Aim provides broad categories of goals to pursue to maintain and improve healthcare. Within each goal are many issues that, if addressed successfully, may have a positive impact on outcomes. For example, healthcare leaders are being tasked to shift from an emphasis on disease management often provided in an acute care setting to health promotion and disease prevention delivered in primary care settings. Efforts in this area can have significant positive impacts by reducing the need for primary healthcare and by reducing the stress on the healthcare system.
Changes in the industry only serve to stress what has always been true; namely, that the healthcare field has always faced significant challenges, and that goals to improve healthcare will always involve multiple stakeholders. This should not seem surprising given the circumstances. Indeed, when a growing population needs care, there are factors involved such as the demands of providing that care and the rising costs associated with healthcare. Generally, it is not surprising that the field of healthcare is an industry facing multifaceted issues that evolve over time.
In this module’s Discussion, you reviewed some healthcare issues/stressors and selected one for further review. For this Assignment, you will consider in more detail the healthcare issue/stressor you selected. You will also review research that addresses the issue/stressor and write a white paper to your organization’s leadership that addresses the issue/stressor you selected.
To Prepare:
- Review the national healthcare issues/stressors presented in the Resources and reflect on the national healthcare issue/stressor you selected for study.
- Reflect on the feedback you received from your colleagues on your Discussion post for the national healthcare issue/stressor you selected.
- Identify and review two additional scholarly resources (not included in the Resources for this module) that focus on change strategies implemented by healthcare organizations to address your selected national healthcare issue/stressor.
Week 2
The Assignment (3-4 Pages):
Analysis of a Pertinent Healthcare Issue
Develop a 3- to 4-page paper, written to your organization’s leadership team, addressing your selected national healthcare issue/stressor and how it is impacting your work setting. Be sure to address the following:
- Describe the national healthcare issue/stressor you selected and its impact on your organization. Use organizational data to quantify the impact (if necessary, seek assistance from leadership or appropriate stakeholders in your organization).
- Provide a brief summary of the two articles you reviewed from outside resources on the national healthcare issue/stressor. Explain how the healthcare issue/stressor is being addressed in other organizations.
- Summarize the strategies used to address the organizational impact of national healthcare issues/stressors presented in the scholarly resources you selected. Explain how they may impact your organization both positively and negatively. Be specific and provide examples.
Sample Paper – Week 2 Assignment
NURS 6053 – Review of Current Healthcare Issues
Curbing Healthcare Costs
Student’s Name:
Institutional Affiliation:
The cost of healthcare in the U.S both at the national level and at the organizational level is astonishing. The United States ranks at number 37 among the countries with advanced healthcare systems, yet it is the largest spender in healthcare. The huge cost of healthcare causes a financial burden to households and citizens of the United States as they have to shoulder the transferred costs as organizations strive to make profits. The citizens also have to pay higher premiums, pay taxes, and also incur extra costs on other services related to healthcare, such as acquiring over the counter medication. Some of the factors that make healthcare costs high are drugs cost, administrative costs, expensive combinations of treatment, defensive medicine, and staff wages. Dividing the healthcare expenditure budget at the national level, 59% of it caters for doctors, hospitals, and clinical services (Amadeo, 2019). The expenditure on medication rises year after year at a rate of 3.3%. The increased expenditure on healthcare is not attributed to increased use of healthcare services but rather increased prices of constituent elements in the budget. This paper aims to focus more on expenditure at the organizational level to try and find strategies that may mitigate the problem.
Impact of High Costs at the Organization
Although hospitals have the aim of providing safe and quality care to promote public health, they at time, operate as businesses as they have to ensure they do not incur losses. The need to make profits is threatened by increasing expenditures, which is a constraint to the profit margins. Healthcare costs at the organizational level replicate that at the national level. The cost of acquiring several necessary products and services is very high, while some practices within the facility contribute to increased costs. One of the practices that replicate that at the national level is wastage. It is estimated that thirty percent of the budget on healthcare goes to waste. Some of the activities that create an avenue for wastage are on over-prescription of antibiotics, paperwork adds to administrative costs and fraud. According to the CDC (2019), the rate of Opioid Prescriptions made in 2017 was averagely 58.7 prescriptions per 100 people. Overprescribing antibiotics account for over $ 210 billion, paperwork costs $190 billion, while fraud did see expenses of nearly $200 billion annually (Amadeo, 2019).
The other factor that increases the cost of healthcare is the heavy use of healthcare services by patients that cannot afford; hence, most of the bills are written off as bad debts. Though the outcomes may be positive health-wise on the patient, the hospital resources are used without anyone accounting for it. Some patients overspend on their insurance beyond the required limits forcing insurance companies to neglect them. On the other hand, reducing the number of medical errors reduces unnecessary expenses and wastage of resources on care and lawsuits. Physicians are afraid of lawsuits and tend to order multiple tests on a patient, yet from the diagnosis, they understand where the problem lies (Amadeo, 2019). According to a research in 2010 by Gallup survey attributed $650 billion wasted on defensive medicine. Offering quality and safe care can save the hospital the costs caused by a minor population such as the elderly who have multiple and expensive to cater for chronic illnesses.
The cost of supplies and healthcare technology at the facility is very high, considering the need to focus more on disease prevention and health promotion rather than on disease management (Epstein et al., 2014). The center is facing a stiff challenge of acquiring current technologies, implementing I.T infrastructure and various medical devices and prescription drugs. Implementing technology in care provision has the advantage of reducing costs, minimizing wastage, reducing errors, ensuring safety, and improving the quality of care. Our facility is over utilizing old technologies as the budgets of acquiring new devices are high, but at times there are no choices left but to constrain the budget and acquire new systems to be at par with the requirement to provide quality-based care. According to the report by AHA, annually, hospitals in the U.S collectively spend over $47 billion on health I.T, and that was between 2010-2014 (LaPointe, 2017). Costs of other supplies such as food, drugs, and medical equipment at times fall beyond the control of the organization as the suppliers set their prices considering factors such as inflation, taxes, transportation, and profitability thus hiking their prices.
The cost of remuneration of physicians, nurses, and specialists at the organization accounts for nearly half of the budget. The thought to cut back on staff is not possible considering the rising demand for care, and it may increase the workload on the few staff members, thus affecting productivity. Specialists account for higher wages; no wonder the cost of their services is high.
Reviewed Articles
The article by Navathe et al., (2017) uses an example case of the cost of replacing a joint to assess how a hospital can save on expenses. From the study, the most significant of savings came from supplies and implants, while post-acute care savings originated from reduced use of institutional care. The use of post-acute services and reduced prices of implants are simple measures that can be implemented without the need to invest heavily in care coordination. The study utilized 3942 patients at the Baptist Health System (BHS) with the need for lower extremity joint replacement. The study observed readmission rates, length of stay, emergency department visits, and hospital savings from reduced internal costs and post-acute care spending. The outcomes of the study are that it is possible to lower organizational cost, improve care coordination, and quality. The Baptist saw a reduction of implant costs by a 30% margin. The Institution used their surgeons to make a choice of the best implants in the market, identify manufactures with better prices, review medical evidence, and finally chose manufacturers that met the demands and price. The manufacturers engaged in online bidding at competitively lower prices while at the same time met the quality of products that surgeons required.
According to a study by Dexter & Wachtel (2014), they propose several strategies for checking costs and increasing shared decision-making, patient safety, and quality by minimizing wastage. The authors acknowledge that the healthcare sector uses interventions with higher costs by the justification that the health outcomes will be positive on the patient. The study uses the context of a medical home with anesthesiologists in charge of care, although the strategies applied can be used in different care settings. The article focuses on specific areas and does propose that the management can capitalize on applying medical informatics and analytics. The authors suggest on first eliminating unnecessary interventions that are not of significant benefit to the patient, and they should be evidence-based.
Data from analytics can be used to detect wastage, and the best thing when taking action is that no one can resist wastage (Dimitrov, 2016). The other factor that the authors consider is human capital. Staff needs to be coordinated such that they are scheduled, patients are booked and the right care giver assigned the task hence saving time and avoiding wastage of resources. Another strategy is to minimize the habit of cancelling patient schedules as they come at a cost. Dexter &Wachtel (2014) do also propose on reducing the time spent on given healthcare services to increase productivity. When considering healthcare, they can be accounted as variable costs, and the more time spent on a service, the costly they become. The quality of service needs to be improved to minimize a patient’s length of stay. To sum it up, the article focuses on service improvement for quality outcomes at reduced costs and on capitalizing on information and data from I.T infrastructures at the care center.
Strategies Used To Address the Organizational Impact of the High Costs of Expenditure
The concern for the high costs of healthcare has been there for years now, and different methods of dealing with the problem have been proposed. Various experts and scholars suggest ideas related to capitating some form of products and services. Current proposals though focus on Value-based care, population management, Accountable Care Organizations, and clinical outcomes (Epstein et al., 2014). Such proposal aims to cut back on unnecessary use of resources via quality and safe care. The management of some organizations focuses on prioritizing products and services and where necessary, use smart technologies and ideas such as recycling and tech with multi-functionality. Other approaches of cutting on healthcare costs have been on the promotion of fair competition and transparency on the suppliers’ part with the expectation that hospitals will benefit on quality products and services at lower costs. This has become a challenge as most suppliers have grown in size and network to take a monopolistic form. It is worth to note that there are healthcare organizations that have capitalized on procurement ideas such as forming group-purchasing organizations to take advantage of discounts from buying in bulk and having a higher negotiating power. Some organizations cut back on the costs of specialists by capitalizing on the ability of nurses and physicians to provide the same service as specialists at a cheaper cost.
From the two articles by Dexter & Wachtel (2014) and Navathe et al. (2017), it is worth to note that there is no specific strategy that can reduce the cost of healthcare in an organization independently but rather a strategy of multiple solutions should be applied. The two articles share the similarity of focusing on the quality of services and competency of staff in improving the quality of care and the use of technology in streamlining care. Nurses, physicians, and other care specialists need to be involved in analysis, budgeting, and in decision making, especially when planning on acquiring supplies as they have the knowledge to review quality products. Organizations also need to have a team that specializes in procurement by reviewing terms of suppliers and make a deal with the suppliers that provide competitive prices for quality products. Since the cost of human capital remains high, the strategy should be optimally utilizing the available staff such as nurses since they have the knowledge and skill to provide various care services. Cost of supplies such as equipment and drugs among other infrastructure can be negotiated and the terms with suppliers reviewed.
References
Amadeo, K. (2019). Health care cost facts. Retrieved from https://www.thebalance.com/healthcare-costs-3306068
Centers for Disease Control and Prevention. CDC. (2019). U.S. Opioid Prescribing Rate Maps | Drug Overdose | CDC Injury Center. Retrieved from https://www.cdc.gov/drugoverdose/maps/rxrate-maps.html
Dexter, F., &Wachtel, R. E. (2014). Strategies for net cost reductions with the expanded role and expertise of anesthesiologists in the perioperative surgical home. Anesthesia & Analgesia, 118(5), 1062-1071.
Dimitrov, D. V. (2016). Medical internet of things and big data in healthcare. Healthcare informatics research, 22(3), 156-163.
Epstein, A. M., Jha, A. K., Orav, E. J., Liebman, D. L., Audet, A. M. J., Zezza, M. A., &Guterman, S. (2014). Analysis of early accountable care organizations defines patient, structural, cost, and quality-of-care characteristics. Health Affairs, 33(1), 95-102.
Navathe, A. S., Troxel, A. B., Liao, J. M., Nan, N., Zhu, J., Zhong, W., & Emanuel, E. J. (2017). Cost of joint replacement using bundled payment models. JAMA internal medicine, 177(2), 214-222.
Looking Ahead
The paper you develop in Module 1 will be revisited and revised in Module 2. Review the Assignment instructions for Module 2 to prepare for your revised paper.
By Day 7 of Week 2
Submit your paper.
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
- Please save your Assignment using the naming convention “WK2Assgn+last name+first initial.(extension)” as the name.
- Click the Week 2 Assignment Rubric to review the Grading Criteria for the Assignment.
- Click the Week 2 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
- Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK2Assgn+last name+first initial.(extension)” and click Open.
- If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
- Click on the Submit button to complete your submission.
Grading Criteria
To access your rubric:
Week 2 Assignment Rubric
Check Your Assignment Draft for Authenticity
To check your Assignment draft for authenticity:
Submit your Week 2 Assignment draft and review the originality report.
Submit Your Assignment by Day 7 of Week 2
To submit your Assignment:
Week 2 Assignment
Next Module
To go to the next Module:
Module 2
Module 2: Professionalism (Week 3)
Laureate Education (Producer). (2018). Moral Leadership [Video file]. Baltimore, MD: Author.
Learning Objectives
Students will:
- Analyze the impact of competing needs of workforce, resources, and patients on policy development
- Analyze the impact of competing needs on healthcare issues/stressors
- Analyze policies and practices for healthcare issues/stressors
- Critique organizational policies and practices for ethical considerations
- Recommend policy or practice changes to balance competing needs and ethical considerations
| Due By | Assignment |
| Week 3, Days 1–2 | Read the Learning Resources. Compose your initial Discussion post. |
| Week 3, Day 3 | Post your initial Discussion post. Begin to compose your Assignment. |
| Week 3, Days 4-5 | Review peer Discussion posts. Compose your peer Discussion responses. Continue to compose your Assignment. |
| Week 3, Day 6 | Post two peer Discussion responses. |
| Week 3, Day 7 | Deadline to submit your assignment. |
Photo Credit: on_WAL_CBLE0001_er1_EN.mov – Freeze frame
Learning Resources
Required Readings
American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. Silver Spring, MD: Author. Retrieved from https://www.nursingworld.org/coe-view-only
Note: Review all, with special attention to “Provision 6” (pp. 23–26).
Kelly, P., & Porr, C. (2018). Ethical nursing care versus cost containment: Considerations to enhance RN practice. OJIN: Online Journal of Issues in Nursing, 23(1), Manuscript 6. doi:10.3912/OJIN.Vol23No01Man06. Retrieved from http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-23-2018/No1-Jan-2018/Ethical-Nursing-Cost-Containment.html
Milliken, A. (2018). Ethical awareness: What it is and why it matters. OJIN: Online Journal of Issues in Nursing, 23(1), Manuscript 1. doi:10.3912/OJIN.Vol23No01Man01. Retrieved from http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-23-2018/No1-Jan-2018/Ethical-Awareness.html
Required Media
Laureate Education (Producer). (2012). Ethical, Moral, and Legal Leadership [Video file]. Baltimore, MD: Author.
Laureate Education (Producer). (2009b). Working with Individuals [Video file]. Baltimore, MD: Author.
Discussion: Organizational Policies and Practices to Support Healthcare Issues
Quite often, nurse leaders are faced with ethical dilemmas, such as those associated with choices between competing needs and limited resources. Resources are finite, and competition for those resources occurs daily in all organizations.
For example, the use of 12-hour shifts has been a strategy to retain nurses. However, evidence suggests that as nurses work more hours in a shift, they commit more errors. How do effective leaders find a balance between the needs of the organization and the needs of ensuring quality, effective, and safe patient care?
In this Discussion, you will reflect on a national healthcare issue and examine how competing needs may impact the development of polices to address that issue.
To Prepare:
- Review the Resources and think about the national healthcare issue/stressor you previously selected for study in Module 1.
- Reflect on the competing needs in healthcare delivery as they pertain to the national healthcare issue/stressor you previously examined.
Sample Paper – Week 3 Discussion
NURS 6053 – Organizational Policies and Practices to Support Healthcare Issues
Organizational Policies
Student’s Name:
Institutional Affiliation:
Organizational Policies
How Competing Needs Impact Policy Development
Health care systems in the world face a significant challenge of how to deliver wide access to health services while enhancing the quality of care and controlling costs. The health care providers are highly determined to offer quality care (Kelly & Porr, 2018). However, the health care needs are growing with the increase of the aging population hence the need for more technology to enhance better treatment. The health care providers are not enough to fulfill these needs which cause work overload, hence medical errors which affect the quality of health care. The competing needs can trigger the development of policies that will standardize the running of the health care system. For instance, the Affordable Care Act was introduced to cater for the increasing health care costs so that patients can get quality care even if they are from middle-income homes.
Specific Competing Need that Impacts High Health Care Costs
There are several areas where high health care costs emerge. Examples are increased in the cost of drugs, increase in provider reimbursement, expensive nursing home care and high costs of durable medical equipment which increases expenses in health care costs and sometimes the expenses being transferred to the patients. Nurses should deliver quality health care. Nurses have a professional goal and connected ethical responsibility which should direct the nursing practice (Milliken, 2018). However, this is not the routine in practice. Nurse shortage is one of the problems which hinder that leading to overload which comprises the quality of care. Therefore one of the solutions is to employ more nurses. Other solutions would include using new staff and scheduling system through developing a staffing pool which will help in supplementing the staffing needs (Sikka, Morath, & Leape, 2015). An institution can also use more staff efficiently in an attempt to reduce labor costs and deliver quality care. For instance, In Freeman White blog post, Kristyna Culp estimated that use of nurse to move the sick to and from the emergency unit as compared to utilizing transport employees would increase hospital costs with $111690 annually. The estimation approximate that pay rate of $19.50 in a transport staff hourly and $45 per hourly for the nurses and an encircling expedition transport time of 30 minutes for every sick person. Moreover, an organization can reduce employee turnover. It is costly to train a new employee. Apart from donating competitive pay, and packages of benefit, some ways of maintaining the current staff are streaming process to simplify staff workload, rewarding and recognizing the staff as well as treating the employees with respect and promoting them (Julie, 2016).
How Policy Might Impact the Competing Needs
Policies can be intended to improve the quality of care and reduce health care costs at the same time. The organization should come up with policies regarding the number of hours that any health care provider should work. In that policy, they can design ways the institution will do to achieve quality care at low costs. The Affordable Care Act, for instance, designed some tools to reduce health care costs. For instance, it created The Center for Medicare and Medicaid innovation or CMMI used for testing delivery methods to lower costs and improve the health care quality of the individuals who benefited from federal health insurance programs (Kivlahan, Orlowski, Pearce, Walradt, Baker, & Kirch, 2016). This is one way of improving the health care quality but it is not related to health caregivers. Generally, it impacts the entire health care system.
References
Julie Henry (2016) 7 ways hospitals can reduce staffing costs without jeopardizing quality https://www.healthcaredive.com/news/7-ways-hospitals-can-reduce-staffing-costs-without-jeopardizing-quality/421236/
Kelly, P., & Porr, C. (2018). Ethical Nursing Care Versus Cost Containment: Considerations to Enhance RN Practice. OJIN: The Online Journal of Issues in Nursing, 23(1).
Kivlahan, C., Orlowski, J. M., Pearce, J., Walradt, J., Baker, M., & Kirch, D. G. (2016). Taking a risk: early results from teaching hospitals’ participation in the center for Medicare and Medicaid innovation bundled payments for a care improvement initiative. Academic Medicine, 91(7), 936-942.
Milliken, A. (2018). Ethical awareness: What it is and why it matters. OJIN: The Online Journal of Issues in Nursing, 23(1).
Sikka, R., Morath, J. M., & Leape, L. (2015). The Quadruple Aim: care, health, cost and meaning in work.
By Day 3 of Week 3
Post an explanation of how competing needs, such as the needs of the workforce, resources, and patients, may impact the development of policy. Then, describe any specific competing needs that may impact the national healthcare issue/stressor you selected. What are the impacts, and how might policy address these competing needs? Be specific and provide examples.
By Day 6 of Week 3
Respond to at least two of your colleagues on two different days by providing additional thoughts about competing needs that may impact your colleagues’ selected issues, or additional ideas for applying policy to address the impacts described.
Submission and Grading Information
Grading Criteria
To access your rubric:
Week 3 Discussion Rubric
Post by Day 3 and Respond by Day 6 of Week 3
To participate in this Discussion:
Week 3 Discussion
Assignment: Developing Organizational Policies and Practices
Competing needs arise within any organization as employees seek to meet their targets and leaders seek to meet company goals. As a leader, successful management of these goals requires establishing priorities and allocating resources accordingly.
Within a healthcare setting, the needs of the workforce, resources, and patients are often in conflict. Mandatory overtime, implementation of staffing ratios, use of unlicensed assisting personnel, and employer reductions of education benefits are examples of practices that might lead to conflicting needs in practice.
Leaders can contribute to both the problem and the solution through policies, action, and inaction. In this Assignment, you will further develop the white paper you began work on in Module 1 by addressing competing needs within your organization.
To Prepare:
- Review the national healthcare issue/stressor you examined in your Assignment for Module 1, and review the analysis of the healthcare issue/stressor you selected.
- Identify and review two evidence-based scholarly resources that focus on proposed policies/practices to apply to your selected healthcare issue/stressor.
- Reflect on the feedback you received from your colleagues on your Discussion post regarding competing needs.
The Assignment (4-5 pages):
Developing Organizational Policies and Practices
Add a section to the paper you submitted in Module 1. The new section should address the following:
- Identify and describe at least two competing needs impacting your selected healthcare issue/stressor.
- Describe a relevant policy or practice in your organization that may influence your selected healthcare issue/stressor.
- Critique the policy for ethical considerations, and explain the policy’s strengths and challenges in promoting ethics.
- Recommend one or more policy or practice changes designed to balance the competing needs of resources, workers, and patients, while addressing any ethical shortcomings of the existing policies. Be specific and provide examples.
- Cite evidence that informs the healthcare issue/stressor and/or the policies, and provide two scholarly resources in support of your policy or practice recommendations.
Sample Paper – Week 3 Assignment
NURS 6053 – Developing Organizational Policies and Practices
Developing Organizational Policies and Practices
Student’s Name:
Institutional Affiliation:
Competing Needs Impacting Hospital Expenditures
The high cost of expenditure may have adverse effects on the performance of an organization. The reason for this is that healthcare organizations need funds for them to operate effectively. As such, the high rate of expenditure means that these facilities remain at a critical point regarding their financial stability, thus, negatively impacting the delivery of care and patient outcomes (Woolhandler et al., 2014). Many competing needs impact the high levels of expenditure incurred by healthcare organizations. The first one is the need by the facility to meet customer expectations, and thus, achieving customer satisfaction. This is a good move because the performance of any hospital depends on its ability to meet the expectations of its customers. This is achieved by offering high-quality services to every client they have. To achieve all these, the organization has to be ready to employ sufficient staff members, has to bring in highly qualified and experienced professionals, and has to ensure that it has enough resources in the form of equipment. All these require heavy investment. An organization needs to have modern equipment, which is very expensive in the market.
Additionally, the cost of hiring qualified and experienced staff is high as compared to average candidates. All these are done by the management as they seek to guide the organization towards the achievement of its goals. Another need here is that of minimizing costs while maximizing profits (Bodenheimer, 2015). For an organization to remain competitive, it has to be financially stable. This depends on the profit margin. The success of a manager is not based solely on customer satisfaction but also on the financial performance of the organization. Therefore, as the leaders and managers strive to meet customer expectations, they also have to ensure that they meet the shareholder expectations. This is a dilemma being faced by organizations as they seek to remain competitive in promoting public health.
This brings in another need whereby as managers seek to maximize profits, employees also want to work in a conducive and better environment. Employees are the most important stakeholders whose productivity determines the performance of an organization. As such, they ought to be treated well, and their interests are taken into consideration. The management may try to reduce the number of employees and purchase cheaper equipment as they seek to cut down expenditure (Sheikh et al., 2015). On the other hand, employees will not accept to be overworked, and they need better equipment for them to deliver high-quality services. The conflicting and competing needs may significantly impact the operational costs of an organization. In such cases, the management needs to find a solution that does not make some parties worse off.
Relevant Policy or Practice
The hospital has adopted various practices aimed at minimizing expenditure, and thus, increase the profit margin. One of the most recognizable practices is the move to embrace technology in most of the operations. The management has divided to cut down the operational and administrative costs by incorporating new technology. This is a good move, considering the dynamics of the modern business environment. The managers assessed the administrative processes of the organization and identified the areas that could be automated through the use of technology (Himmelstein et al., 2014). This significantly reduced the number of employees in the hospital.
In addition to this, the hospital adopted the use of electronic health record systems and other modern technology to minimize the human resources needed. This was done with the consideration of how the move could affect the delivery of services and organizational performance. Also, the adoption of modern technology ensured that human errors are minimized, operational costs are reduced, and the delivery of services is improved (Sloan & Hsieh, 2017). These are the basic factors that the management looked at. With this, several employees lost their jobs. To some people, the move was too severe. However, to the management and the shareholders, the move was necessary because the organization needed sufficient finances for it to run effectively.
Ethical Considerations
Several ethical considerations exist when it comes to the use of technology in the healthcare setting. This is due to the sensitivity of the information and the activities related to health. One of the major ethical considerations is accountability and ethics of work. The use of modern technology has improved accountability and work ethics among healthcare workers. This is due to the increased accessibility and completeness of data records that have been filed electronically (Ozair et al., 2015). With this, professionals can easily follow every detail regarding a given patient. This included diagnoses, health history, symptoms, medical interventions, as well as their effects. Information can also be displayed on computer screens. In addition to this, the data display can be supported by computer-based decision-making tools and basic quality standards. Such things significantly influence accountability of healthcare professionals.
Another ethical consideration is confidentiality or privacy encroachment. This has been the major concern with the new technology. Usually, medical records contain sensitive personal information that needs to be protected by all means. Sharing such data with a third or unauthorized party is a violation of professional ethics and patient’s trust. Modern technology offers several opportunities for the encroachment of the patient-physician relationship. This is because of the existence of many players in the healthcare sector. Once data has been entered and stored electronically, it can be retrieved at any time and by any employee in the hospital (Ozair et al., 2015). This threatens the privacy of patient information, which is a clear violation of the ethical regulations in the sector. Under the issue of privacy, information stored using modern technology can be easily retrieved by hackers. This means that an organization needs to have strong and competent IT professionals to deal with the threat of hackers and protect patient information.
Recommendations for Policy Changes
The facility has done well in its attempt to address the issue of high expenditure levels. The incorporation of new technology has not just addressed the problem but has also improved the delivery of services and patient safety. With this, there has been a positive impact on organizational performance. However, more needs to be done to ensure that the policy does not compromise the ethics of healthcare workers in the hospital. As such, there is a need for policy changes to deal with ethical considerations used. Here, new technology should not completely replace the workforce in the facility. There is still a need for enough staff members to deal with the increasing demand for healthcare services. People can work well with machines to improve the overall organizational performance. For instance, the IT department needs highly qualified and experienced employees who can counter any hacking attempts. This will ensure that privacy policies are not breached. Also, while adopting the new technology, it is imperative to ensure that the process does not negatively impact any stakeholders in the organization.
References
Bodenheimer, T. (2015). High and rising health care costs. Part 1: seeking an explanation. Annals of internal medicine, 142(10), 847-854.
Himmelstein, D. U., Jun, M., Busse, R., Chevreul, K., Geissler, A., Jeurissen, P., … & Woolhandler, S. (2014). A comparison of hospital administrative costs in eight nations: US costs exceed all others by far. Health Affairs, 33(9), 1586-1594.
Ozair, F. F., Jamshed, N., Sharma, A., & Aggarwal, P. (2015). Ethical issues in electronic health records: A general overview. Perspectives in clinical research, 6(2), 73.
Sheikh, A., Sood, H. S., & Bates, D. W. (2015). Leveraging health information technology to achieve the “triple aim” of healthcare reform. Journal of the American Medical Informatics Association, 22(4), 849-856.
Sloan, F. A., & Hsieh, C. R. (2017). Health economics. MIT Press.
Woolhandler, S., Campbell, T., & Himmelstein, D. U. (2014). Costs of health care administration in the United States and Canada. New England Journal of Medicine, 349(8), 768-775.
By Day 7 of Week 3
Submit your revised paper.
Submission and Grading Information
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Week 3 Assignment Rubric
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Submit your Week 3 Assignment draft and review the originality report.
Submit Your Assignment by Day 7 of Week 3
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Next Module
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Module 3
Module 3: Leadership (Weeks 4-6)
Laureate Education (Producer). (2018). The Leader in You [Video file]. Baltimore, MD: Author.
Learning Objectives
Students will:
- Analyze the effectiveness and impact of leadership skills
- Assess personal leadership traits
- Analyze how leadership traits can be applied to personal leadership philosophies and behaviors
- Develop a personal leadership philosophy
- Create a development plan related to personal leadership philosophies
| Due By | Assignment |
| Week 4, Days 1–2 | Read the Learning Resources. Compose your initial Discussion 1 post. |
| Week 4, Day 3 | Post your initial Discussion 1 post. Begin to compose your Assignment. |
| Week 4, Days 4-5 | Review peer Discussion 1 posts. Compose your peer Discussion 1 responses. Continue to compose your Assignment. |
| Week 4, Day 6 | Post two peer Discussion 1 responses. |
| Week 5, Days 1-2 | Compose your initial Discussion 2 post. Continue to compose your Assignment. |
| Week 5, Day 3 | Post your initial Discussion 2 post. Continue to compose your Assignment. |
| Week 5, Days 4-5 | Review peer Discussion 2 posts. Compose your peer Discussion 2 responses. Continue to compose your Assignment. |
| Week 5, Day 6 | Post two peer Discussion 2 responses. |
| Week 6, Days 1- 6 | Continue to compose your Assignment. |
| Week 6, Day 7 | Deadline to submit your Assignment. |
Photo Credit: sturti/Creatas Video/Getty Images
Learning Resources
Required Readings
Marshall, E., & Broome, M. (2017). Transformational leadership in nursing: From expert clinician to influential leader (2nd ed.). New York, NY: Springer.
- Chapter 1, “Expert Clinician to Transformational Leader in a Complex Health Care Organization: Foundations” (pp. 7–20 ONLY)
- Chapter 6, “Frameworks for Becoming a Transformational Leader” (pp. 145–170)
- Chapter 7, “Becoming a Leader: It’s All About You” (pp. 171–194)
Duggan, K., Aisaka, K., Tabak, R. G., Smith, C., Erwin, P., & Brownson, R. C. (2015). Implementing administrative evidence-based practices: Lessons from the field in six local health departments across the United States. BMC Health Services Research, 15(1). doi:10.1186/s12913-015-0891-3. Retrieved from https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-015-0891-3
Resources for the StrengthsFinder Assessment Tool
Rath, T. (2007). Strengths Finder 2.0 – with Access Code.
Purchase the access code from the Walden bookstore. Then follow the instructions in the document “How to Access the Strengths Finder 2.0.
Document: How to Access Strengths Finder 2.0 (PDF)
Required Media
Laureate Education (Producer). (2014). Leadership [Video file]. Baltimore, MD: Author.
Moore Foundation. (n.d.). Nurses share lessons in leadership. Retrieved from https://www.youtube.com/playlist?list=PLopRJPO6GaifsYPGP_jcWXZzU10H3AaX7
Discussion 1: Leadership Theories in Practice
A walk through the Business section of any bookstore or a quick Internet search on the topic will reveal a seemingly endless supply of writings on leadership. Formal research literature is also teeming with volumes on the subject.
However, your own observation and experiences may suggest these theories are not always so easily found in practice. Not that the potential isn’t there; current evidence suggests that leadership factors such as emotional intelligence and transformational leadership behaviors, for example, can be highly effective for leading nurses and organizations.
Yet, how well are these theories put to practice? In this Discussion, you will examine formal leadership theories. You will compare these theories to behaviors you have observed firsthand and discuss their effectiveness in impacting your organization.
To Prepare:
- Review the Resources and examine the leadership theories and behaviors introduced.
- Identify two to three scholarly resources, in addition to this Module’s readings, that evaluate the impact of leadership behaviors in creating healthy work environments.
- Reflect on the leadership behaviors presented in the three resources that you selected for review.
Sample Paper – Week 4 Discussion 1
NURS 6053 – Leadership Theories in Practice
Leadership Theories in Practice
Student’s Name:
Institutional Affiliation:
Leadership Theories in Practice
Leadership refers to a process where an individual influences a group to achieve a common goal (Northouse, 2018). It is not the position or the title that has been given, but something which is earned (Laureate Education, 2014). Different scholars have come up with theories to describe leadership. Examples of these theories are transformational, leader-member exchange among others. This paper will discuss the aspects of leadership and the extent to which the leadership skills of a certain leader were effective and how their practice impacted the workplace.
Two Key Insights
One of the things I have learned about leadership is that it is earned. Labels cannot make a person a leader. One earns leadership by knowing what matters. It does not matter what the role or the rank of an individual is, where they come from. One cannot be a leader if their behaviors do not demonstrate the integrity of doing what is right. Leaders should earn trust. They should act as examples to others and know that trustworthiness takes a character. To trust one requires vales and for none to be trusted one should earn the privilege (Rosenbach, 2018). Another insight I have learned is that leadership is not about you but it is about those that the leaders serve. It does not entail the leader ennobling but bringing others up and the best way that one can earn the title of a leader is through losing themselves in the service of uplifting others and bringing changes which are not based on self-interest but on the interest of the followers (Marshall& Broome, 2017). Besides, leaders should inspire their followers to do better. Generally, a leader should work towards transforming the followers and the organization as a whole (Winkler & Marshall, 2017).
The Leader with who I Have Seen Such Behaviors and Skills
One person that demonstrated the leadership skills discussed above and many others is my supervisor during my internship. He earned trust from us because of his honesty, integrity, and confidence. He stuck to ethical values and core beliefs and whenever there was an issue, good or bad; he used to call us and inform us and even allow us to voice our opinions. This leader also used to inspire and encourage us to do our best. For some of the interns, it was a difficult experiencing transition from a class to real practice. However, the supervisor was there for us and made us feel that everything is possible. With no time we got used and even started enjoying our work. Everything that he did was for the interest of the interns and not for self-interest. For instance, he once advocated for a policy where the interns would be given compensation after three months in practice since after this period the interns were working like other providers and the managers could entrust them with practice.
How the Skills and Practice Impacted the Workplace
Through building a strong relationship with the interns by creating trust, we could work as a team and accomplish a lot. The interns who were fast learners could willingly help the slow learners and be patient with them just like our supervisor was patient with us. One of the qualities of a leader is patience and the supervisor demonstrated that. Through having the interest of interns at hand, there was a transformation in the organization since the hospital started employing the interns because of the good work they were doing. The interns were highly motivated and they offered high-quality services.
References
Laureate Education (Producer). (2014). Leadership [Video file]. Baltimore, MD: Author
Marshall, E., & Broome, M. (2017). Transformational leadership in nursing: From expert clinician to influential leader (2nd ed.). New York, NY: Springer.
Northouse, P. G. (2018). Leadership: Theory and practice. Sage publications.
Rosenbach, W. E. (2018). Contemporary issues in leadership. Routledge.
Winkler, M., & Marshall, E. (2017). Creating and shaping the organizational environment and culture to support practice excellence. Transformational leadership in nursing: From expert clinician to influential leader, 247-267.
By Day 3 of Week 4
Post two key insights you had from the scholarly resources you selected. Describe a leader whom you have seen use such behaviors and skills, or a situation where you have seen these behaviors and skills used in practice. Be specific and provide examples. Then, explain to what extent these skills were effective and how their practice impacted the workplace.
By Day 6 of Week 4
Respond to at least two of your colleagues on two different days by explaining how the leadership skills they described may impact your organization or your personal leadership, or by identifying challenges you see in applying the skills described.
Submission and Grading Information
Grading Criteria
To access your rubric:
Week 4 Discussion Rubric
Post by Day 3 and Respond by Day 6 of Week 4
To participate in this Discussion:
Week 4 Discussion
Discussion 2: Your Leadership Profile
Do you believe you have the traits to be an effective leader? Perhaps you are already in a supervisory role, but as has been discussed previously, appointment does not guarantee leadership skills.
How can you evaluate your own leadership skills and behaviors? You can start by analyzing your performance in specific areas of leadership. In this Discussion, you will complete Gallup’s StrengthsFinder assessment. This assessment will identify your personal strengths, which have been shown to improve motivation, engagement, and academic self-conference. Through this assessment, you will discover your top five themes—which you can reflect upon and use to leverage your talents for optimal success and examine how the results relate to your leadership traits.
To Prepare:
Complete the StrengthsFinder assessment instrument, per the instructions found in this Module’s Learning Resources.
Please Note: This Assessment will take roughly 30 minutes to complete.
- Once you have completed your assessment, you will receive your “Top 5 Signature Themes of Talent” on your screen.
- Click the Download button below Signature Theme Report, and then print and save the report. We also encourage you to select the Apply tab to review action items.
NOTE: Please keep your report. You will need your results for future courses. Technical Issues with Gallup:
If you have technical issues after registering, please contact the Gallup Education Support group by phone at +1.866-346-4408. Support is available 24 hours/day from 6:00 p.m. Sunday U.S. Central Time through 5:00 p.m. Friday U.S. Central Time.
- Reflect on the results of your Assessment, and consider how the results relate to your leadership traits.
Sample Paper – Week 4 Discussion 2
NURS 6053 – Leadership Theories in Practice
Effective Leadership
Student’s Name:
Institutional Affiliation:
Course Title
Due Date
Effective Leadership
Effectiveness in leadership is not achievable overnight. It involves an iterative process that requires one to assess and evaluate their strengths as collaborators and communicators continuously and their weaknesses. An ineffective leader, for example, can cost a company more fortunes than their morale. According to the Gallup research, poor management affects over 25 percent of employees by disengaging them. Such disengagement often leads to low productivity, profitability, and high employee turnovers. Effective leadership does not have a single agreed or right way of leading a team. Successful leaders have several traits that are common among themselves. Effective nursing leaders are those who help in communicating the hospital’s vision and goals, influence change, and guide their teams.
Leadership Profile
Similar to any other individual, I possess unique behavioral styles baked into me while growing up. Together with these styles, I also have some typical approaches, with some working in my favor throughout the advancement into my current role as a leader. Several scholars have identified different characteristics that effective leaders should possess. As a leader, I believe my most outstanding trait is the ability to identify the strengths and weaknesses of my team. This ability helps me in improving my leadership style since I am always on the front line in identifying these strengths and improving the areas of weaknesses. From the Gallup’s StrengthsFinder, my strengths as a leader include empathy, learner, connectedness, achiever, and an include (Gallup, 2019). My position as a nurse supervisor requires me to be aware of my strengths since I play a formal leadership role within the department.
Strengths
From the report, my two strengths are connectedness and learner. According to Gallup, a learner is someone who desires to improve their abilities by wanting to know more. Also, learning is essential as the competency of a nurse comes from the acquired skills and knowledge (Poorchangizi et al., 2017). Connectedness requires that one entrust his faith in having connections and links. A connected leader understands that everything happens for a reason, and the meaning of each event is essential. By nurturing connectedness, I am likely to influence individuals into realizing the importance of group efforts and teamwork in accomplishing assigned tasks.
Core Values
In the nursing profession, there are core values that act as standard requirements for all educational and clinical nursing environments. These core values not only guide individuals, but they also help in motivating the nurses’ professional behaviors depending on their fields of specialization and working environments. There are several leadership values that one can choose. The standout ones for me are the commitment to use evidence-based care and be open to different opinions. These two values work closely with being empathic and an includer.
Characteristics
Individualization and adaptability are the two characteristics that need strengthening. Being adaptable is equivalent to being flexible and without a fixed perspective on aspects. Working as a nurse leader, for example, in the emergency department, requires me to become accustomed to having stressful situations (Jamshidi et al., 2016). Managing to show how adaptable these situations are will influence my team by making them feel that they are not alone. Adaptability is also crucial in leadership since even stable situations may sometimes become uncomfortable, especially when new challenges arise. Individualization will allow me to understand the uniqueness of each team member and the different roles they play. Individualization requires that I pay close attention to my colleagues’ attitudes, skills, and interests to help them reach their highest potentials.
Conclusion
Effective leadership requires leaders to influence their teams and lead them forward with motivation, inspiration, enthusiasm, and passion. As a leader, it is necessary to invest time in the team to understand their priorities, needs, weaknesses, and strengths and help them improve. Understanding the needs and preferences of a team makes them feel valuable, and the leader will understand the best ways to keep them motivated. To understand others, a leader needs to understand himself or herself first, his areas of strength and weakness, the core values needed, and the characteristics they need to develop.
References
Gallup. (2019). Clifton StrengthsFinder 2.0. Retrieved from https://walden.gallup.com
Jamshidi, N., Molazem, Z., Sharif, F., Torabizadeh, C., & Najafi Kalyani, M. (2016). The challenges of nursing students in the clinical learning environment: A qualitative study. The Scientific World Journal, 2016, 1-7. https://doi.org/10.1155/2016/1846178
Poorchangizi, B., Farokhzadian, J., Abbaszadeh, A., Mirzaee, M., & Borhani, F. (2017). The importance of professional values from clinical nurses’ perspective in hospitals of a medical university in Iran. BMC Medical Ethics, 18(1). https://doi.org/10.1186/s12910-017-0178-9
By Day 3 of Week 5
Post a brief description of your results from the StrengthsFinder assessment. Then, briefly describe two core values, two strengths, and two characteristics that you would like to strengthen based on the results of your StrengthsFinder assessment. Be specific.
By Day 6 of Week 5
Respond to at least two of your colleagues on two different days by making recommendations for how they might strengthen the leadership behaviors profiled in their StrengthsFinder assessment, or by commenting on lessons to be learned from the results that can be applied to personal leadership philosophies and behaviors.
Submission and Grading Information
Grading Criteria
To access your rubric:
Week 5 Discussion Rubric
Post by Day 3 and Respond by Day 6 of Week 5
To participate in this Discussion:
Week 5 Discussion
Assignment: Personal Leadership Philosophies
Many of us can think of leaders we have come to admire, be they historical figures, pillars of the industry we work in, or leaders we know personally. The leadership of individuals such as Abraham Lincoln and Margaret Thatcher has been studied and discussed repeatedly. However, you may have interacted with leaders you feel demonstrated equally competent leadership without ever having a book written about their approaches.
What makes great leaders great? Every leader is different, of course, but one area of commonality is the leadership philosophy that great leaders develop and practice. A leadership philosophy is basically an attitude held by leaders that acts as a guiding principle for their behavior. While formal theories on leadership continue to evolve over time, great leaders seem to adhere to an overarching philosophy that steers their actions.
What is your leadership philosophy? In this Assignment, you will explore what guides your own leadership.
To Prepare:
- Identify two to three scholarly resources, in addition to this Module’s readings, that evaluate the impact of leadership behaviors in creating healthy work environments.
- Reflect on the leadership behaviors presented in the three resources that you selected for review.
- Reflect on your results of the CliftonStrengths Assessment, and consider how the results relate to your leadership traits.
Sample Paper – Week 5 Assignment
NURS 6053 – Personal Leadership Philosophies
Personal Leadership Philosophies
Student’s Name:
Institutional Affiliation:
Course:
Instructor:
Date:
Personal Leadership Philosophy
This paper’s main purpose is to point out some of my philosophies concerning every individual’s leadership. Leadership is a very strong thing to me. It is important to identify the kind of person I am, which usually guides me in life, my followers, what these followers expect from my leadership, and similarly what I want for my leadership.
Core Values
As a leader, my personal core values includes consistency, harmony, discipline, responsibility and effective communication. These particular values are essential to me since I make my own decisions in daily activities. According to my perception, good leadership should involve effective communication, discipline and a sense of responsibility. My personal values are consistent with my personal and professional philosophy, as my values have been the driving force in everything I aim at achieving. To ensure that, I usually follow my philosophies every day, I have to keep several things in my mind that we are all human beings, and no one is perfect despite the effort that everyone makes to be the best.
Mission/Vision Statement
My mission is to serve as a healthcare leader, champion the best outcomes all the time for my patients, and use all ethical principles to make a notable difference. My vision statement is to be a successful health care expert who can influence millions of individuals relating to their health and enact their best outcomes.
Clifton Strengths Assessment Results Analysis
After performing Clifton Strengths Assessment, results revealed that I was consistent, responsible, disciplined, harmonious and an effective communicator. It could also reveal that I was a continuous learner, relator, and an achiever following these strengths (Arenson 2019). These outcomes, thus, signify my key beliefs as a leader and core values that form the foundation of my leadership philosophy.
As a learner, I significantly value disciplined constant learning as opposed to the organized learning forms that occur at a particular time. In the performance of duty, I reliably enroll in a constant learning program to expand my different areas and encourage sensible learning between my subordinates. In healthcare, disciplined continuous learning is thus significant to guarantee that organization is always familiarizing with new trends in industries and new improvements that help produce better results (Sfantou et al., 2017). Another type of disciplined continuous learning I have embraced and reliably used is learning from past mistakes. This, therefore, is possible through reliable evaluations of the previous work I conduct and inspire my team to do and seek to learn from their past insufficiencies, gaining new perceptions on how to face challenges in the future.
As a leader, I am similarly responsible towards planning in that I am fast in taking note of trends and themes in the industry, steering my team to adjust to such trends. Being responsibly organized comes from my preference for transformational leadership behaviors and my trust that I work in a vibrant field. This thus helps me forestall the issues or challenges, draw up the solutions, and similarly layout the future objectives and plans that my team may follow. As a leader am also very consistence, a value that makes me reliably take time to find reasons for different issues and occurrences and their effects and causes. Being consistence makes me capable of finding resolutions for different challenges in the healthcare environment and reliably adopt the demands of the work environment. According to Hargett et al. (2017), the leaders must, thus, endorse logical skills between their subordinates as they will be vibrant in determining future and present problems in the organization, making the organizations more advanced.
As a leader, I am also an excellent achiever enhanced by effective communication. I reliably set the goals and works towards achieving them in a specified time frame. As an achiever, I have involved all my team members and encouraged them to work toward a common goal. Achievement of such goals is thus measured by SMART tools (Smith et al, 2018). Lastly, as a leader, I am a harmonious relator that makes me more anxious with individual relationships during the work process. This embraces relationships with my assistants or with customers. I sustain an open correlation with the subordinates and open communication lines that helps enhance our relationship. The clients are also encouraged to afford feedback, and the workers are encouraged to begin a relationship with clients and show them they care for the clients’ plight (Hargett et al., 2017). As a leader, I believe that the relationship between all the stakeholders is the foundation of organizational success.
Key Behaviors to Strengthen in Future
The two key behaviors I would wish to support are embracing a more disciplined coaching attitude and practice more effective communication and listening in the organization. According to Toussaint & Ehrlich (2017), the employees’ development outcomes will be best attained when the leader is elaborate in such procedures. By approving a disciplined coaching attitude, I would thus develop a partnership with my subordinates and come up with a shared vision and how such vision could be attained. By being a more effective communicator and listener, I would also improve communication skills and good trust with the subordinates such that it would be easier to acquire them to buy into my vision as a leader (Toussaint & Ehrlich, 2017).
Plan to Improve the two Key Behaviors and Attain Personal Vision
To embrace a more disciplined coaching mentality, I expect to delegate in ways that develop the team members, emphasize supporting processes applied by the team members, afford constructive feedback when the team members make mistakes, and reliably offer a credit of effort. To be a more active communicator and listener, I plan to: concentrate on the speaker’s main points and make the speaker know I heard them, fully practice being present whenever talking to the subordinates and continually be open-minded and inquisitive (Toussaint & Ehrlich, 2017). To attain my mission, I will require to keep pursuing specialized excellence in the current organization to ascend to upper leadership positions and have greater influence.
Colleague’s Feedback on the Clifton Strengths Assessment
In relation to the results of my Clifton Strengths Assessment, my colleagues believed that my strengths of consistency, harmony, responsibility, disciplined and effective communicator revealed that I was a balanced leader who was sufficiently suited to the healthcare industry and who had a great possibility of succeeding (Strengths Finder: Gallup 2018).
References
Arenson, A. (2019). Lean Into Your Strengths: An Analysis of Clifton Strengths Data at CU Boulder. Projects in Applied Data Science: Fall 2019.
Hargett, C. W., Doty, J. P., Hauck, J. N., Webb, A. M., Cook, S. H., Tsipis, N. E., … Taylor, D.C. (2017). Developing a model for effective healthcare leadership: a concept mapping approach. Journal of healthcare leadership, 9, 69–78. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5774455/
Sfantou, D. F., Laliotis, A., Patelarou, A. E., Sifaki-Pistolla, D., Matalliotakis, M., & Patelarou, E. (2017). Importance of Leadership Style towards Quality of Care Measures in Healthcare Settings: A Systematic Review. Healthcare (Basel, Switzerland), 5(4), 73.
Smith, T., Fowler-Davis, S., Nancarrow, S., Ariss, S. M., Enderby, P., (2018). “Leadership in interprofessional health and social care teams: a literature review,” Leadership in Health Services, Vol. 31 Issue: 4, pp.452-467. https://www.emerald.com/insight/content/doi/10.1108/LHS-06-2016-0026/full/html
Strengths Finder: Gallup. (2018). https://walden.gallup.com
Toussaint, J.S., & Ehrlich, S.P. (2017). Five Changes Great Leaders Make to Develop an Improvement Culture. Journal of healthcare leadership, 13, 15–18.
Week 6
The Assignment (2-3 pages):
Personal Leadership Philosophies
Develop and submit a personal leadership philosophy that reflects what you think are characteristics of a good leader. Use the scholarly resources on leadership you selected to support your philosophy statement. Your personal leadership philosophy should include the following:
- A description of your core values
- A personal mission/vision statement
- An analysis of your CliftonStrengths Assessment summarizing the results of your profile
- A description of two key behaviors that you wish to strengthen
- A development plan that explains how you plan to improve upon the two key behaviors you selected and an explanation of how you plan to achieve your personal vision. Be specific and provide examples.
- Be sure to incorporate your colleagues’ feedback on your CliftonStrengths Assessment from this Module’s Discussion 2.
To Prepare:
Identify two to three scholarly resources, in addition to this Module’s readings, that evaluate the impact of leadership behaviors in creating healthy work environments. Reflect on the leadership behaviors presented in the three resources that you selected for review. Reflect on your results of the CliftonStrengths Assessment, and consider how the results relate to your leadership traits. The Assignment (2-3 pages):
Sample Paper – Week 6 Assignment
NURS 6053 – Personal Leadership Philosophies
Personal Leadership Philosophies
Student’s Name:
Institutional Affiliation:
Personal Leadership Philosophies
Nursing leadership is crucial in achieving high-quality care to the patient and ensures that there are favorable outcomes in the organization. Effective leadership ensures that there is a healthy relationship that promotes mutual benefits for both the organization and the respective employees (Duggan, Aisaka, Tabak, Smith, Erwin & Brownson, (2015). A leader promotes cohesion, influences, and advocates for patients and employee needs.
Core Value
Values help nurses and other nursing professionals to provide quality health care to patients. Moreover, it enhances their interaction with the other colleagues. Caring, empathy, effective communication, integrity, and servant leadership are the core values that guide my practice. Through caring and empathy values, it has enabled me to provide individualized care to the patients. Besides, I have been able to enhance career development for other nurses, although at times, it may not be favorable for me to do so (Marshall & Broome, 2017). Effective communication has significantly impacted my career. I can understand patients and provide quality health care to them. Moreover, I can understand the needs of the patients and address them.I am devoted to guiding emerging nurses to adjust to nursing practice.
Mission / Vision Statement
My mission is to ensure that there are holistic and mutual benefits of all nurses through influencing them to be better. Also, through this interaction, I am able to learn about my shortcomings and improve them to become a better leader.
Analysis of Clifton Strengths Feedbacks to Colleagues
Clifton’s assessment is essential in a nurse since it helps to discover what best for and an individual, and how they can develop their talents into strengths. Also, it enables the usage of personalized results to maximize one’s potentials (Gallup, 2019). In nursing practice, nurses should always learn from their past mistakes to become better leaders. Nurses should always influence others to become better in their day to day activities. As a leader, I strive to bring the best in students in my unit. I shape them on how to be better individuals in the future.
Despite, the challenges that exist, nurses should work for greater of all, no matter the problems that they may experience. As a nurse, I always perform my duties professionally and follow all guidelines outlined in a nursing career. The nursing profession is ever-changing, and nurses need to adjust accordingly. The only way to do so is to ensure that I am updated with the advancements. A nurse should always take responsibility for their actions and always be accountable. I make it my obligation to promote the welfare of others, even if it does not please me (Gallup, 2019). My strategic role has been emphasized because I am a nurse in charge of the unit. This role has enabled me to manage conflicts in the group. Moreover, I can identify the issues that are of significance to the unit and solve them. Also, I learn from others, and this has made me an effective leader.
Behaviors I wish to Strengthen
In the unit I am in charge of, there are behaviors that I seek to promote. There is no teamwork among the employees, and this has affected operations in the unit. Moreover, I would strive to encourage my personal development as well as of those of my subordinates.
Plans to Improve the Two Behaviors’
Through team-building activities of the employees’ cohesion will be promoted. My subordinates will be able to offer a helping hand to each other and enhance quality health care in the clinical setting. Also, I will improve my leadership skills by advancing my education, as well as seeking political positions. This will ensure that I can effectively advocate the needs of the patients and the welfare of all employees.
References
Duggan, K., Aisaka, K., Tabak, R. G., Smith, C., Erwin, P., & Brownson, R. C. (2015). Implementing administrative evidence based practices: lessons from the field in six local health departments across the United States. BMC health services research, 15(1), 221.
Gallup, G. (2019, September 21). StrengthsFinder 2.0. Retrieved from https://www.gallup.com/cliftonstrengths/en/254033/strengthsfinder.aspx
Marshall, E., & Broome, M. (2017). Transformational Leadership in Nursing: From Expert
Clinician to Influential Leader. (2nd ed.). New York, NY: Springer.
By Day 7 of Week 6
Submit your personal leadership philosophy.
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
- Please save your Assignment using the naming convention “WK6Assgn+last name+first initial.(extension)” as the name.
- Click the Week 6 Assignment Rubric to review the Grading Criteria for the Assignment.
- Click the Week 6 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
- Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK6Assgn+last name+first initial.(extension)” and click Open.
- If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
- Click on the Submit button to complete your submission.
Grading Criteria
To access your rubric:
Week 6 Assignment Rubric
Check Your Assignment Draft for Authenticity
To check your Assignment draft for authenticity:
Submit your Week 6 Assignment draft and review the originality report.
Submit Your Assignment by Day 7 of Week 6
To submit your Assignment:
Week 6 Assignment
Next Module
To go to the next Module:
Module 4
Module 4: Communication and Relationship Building (Weeks 7-9)
Laureate Education (Producer). (2018). Diagnosis: Communication Breakdown [Video file]. Baltimore, MD: Author.
Learning Objectives
Students will:
- Assess work environments for workplace civility
- Analyze strategies to address workplace incivility
- Analyze evidence-based theories for promoting organizational health
- Recommend strategies for improving workplace environments
| Due By | Assignment |
| Week 7, Days 1–2 | Read the Learning Resources. Compose your initial Discussion post. |
| Week 7, Day 3 | Post your initial Discussion post. Begin to compose your Assignment. |
| Week 7, Days 4-5 | Review peer Discussion posts. Compose your peer Discussion responses. Continue to compose your Assignment. |
| Week 7, Day 6 | Post two peer Discussion responses. |
| Week 8, Days 1-7 | Continue to compose your Assignment. |
| Week 9, Days 1-6 | Continue to compose your Assignment. |
| Week 9, Day 7 | Deadline to submit your Assignment. |
Photo Credit: [Steve Debenport]/[ E+]/Getty Images
Learning Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
Marshall, E., & Broome, M. (2017). Transformational leadership in nursing: From expert clinician to influential leader (2nd ed.). New York, NY: Springer.
- Chapter 5, “Collaborative Leadership Contexts: Networks, Communication, Decision Making, and Motivation” (pp. 121–144)
- Chapter 9, “Creating and Shaping the Organizational Environment and Culture to Support Practice Excellence” (pp. 247–278)
- Chapter 10, “Building Cohesive and Effective Teams” (pp. 279–298)
Select at least ONE of the following:
Clark, C. M., Olender, L., Cardoni, C., & Kenski, D. (2011). Fostering civility in nursing education and practice: Nurse leader perspectives. Journal of Nursing Administration, 41(7/8), 324–330. doi:10.1097/NNA.0b013e31822509c4
Note: You will access this article from the Walden Library databases.
Clark, C. M. (2018). Combining cognitive rehearsal, simulation, and evidence-based scripting to address incivility. Nurse Educator. doi:10.1097/NNE.0000000000000563
Note: You will access this article from the Walden Library databases.
Clark, C. M. (2015). Conversations to inspire and promote a more civil workplace. American Nurse Today, 10(11), 18–23. Retrieved from https://www.americannursetoday.com/wp-content/uploads/2015/11/ant11-CE-Civility-1023.pdf
Griffin, M., & Clark, C. M. (2014). Revisiting cognitive rehearsal as an intervention against incivility and lateral violence in nursing: 10 years later. Journal of Continuing Education in Nursing, 45(12), 535–542. doi:10.3928/00220124-20141122-02
Note: You will access this article from the Walden Library databases.
Document: Work Environment Assessment Template (Word document)
Required Media
TEDx. (2017, April). Jody Hoffer Gittell: The power of a simple idea [Video file]. Retrieved from https://www.youtube.com/watch?v=X7nL5RC5kdE
Laureate Education (Producer). (2009a). Working with Groups and Teams [Video file]. Baltimore, MD: Author.
Week 7
Discussion: Workplace Environment Assessment
How healthy is your workplace?
You may think your current organization operates seamlessly, or you may feel it has many issues. You may experience or even observe things that give you pause. Yet, much as you wouldn’t try to determine the health of a patient through mere observation, you should not attempt to gauge the health of your work environment based on observation and opinion. Often, there are issues you perceive as problems that others do not; similarly, issues may run much deeper than leadership recognizes.
There are many factors and measures that may impact organizational health. Among these is civility. While an organization can institute policies designed to promote such things as civility, how can it be sure these are managed effectively? In this Discussion, you will examine the use of tools in measuring workplace civility.
To Prepare:
- Review the Resources and examine the Clark Healthy Workplace Inventory, found on page 20 of Clark (2015).
- Review and complete the Work Environment Assessment Template in the Resources.
Sample Paper – Week 7 Discussion
NURS 6053 – Workplace Environment Assessment
|
Work Environment Assessment Template
Use this document to complete the Module 4 Workplace Environment Assessment.
| Summary of Results – Clark Healthy Workplace Inventory | The civility score for my workplace on a scale of (20-100) is 85. This score means that my work environment is moderately healthy. The workplace environment scored highly in the areas concerning how the members live by the vision and mission of the organization. There is a high level of trust among members of the workplace, as evidenced by clear and transparent communication. Employees are valued, and they are viewed as assets, while individual achievement is also collectively celebrated. On the other hand, the workplace environment got an average score on employee’s compensation and remuneration. Similarly, the workload is not equitably distributed, which makes the organization fail to retain their best talents and brightest employees. |
| Identify two things that surprised you about the results. Also identify one idea that you believed prior to conducting the Assessment that was confirmed. | The results were surprising. Firstly, the score correctly matched the level of civility for my organization. Secondly, the results can be used as an essential tool to improve my workplace environment significantly. Before conducting the assessment, I believed that respectfully treating the employees increases the civility of an organization. The assessment confirmed my belief since my organization scored highly as a result of treating employees fairly. |
| What do the results of the Assessment suggest about the health and civility of your workplace? | My workplace civility score is 85. This score implies that my workplace is moderately healthy, and it can be improved to meet the standards of a very healthy workplace environment. |
| Briefly describe the theory or concept presented in the article(s) you selected.
Explain how the theory or concept presented in the article(s) relates to the results of your Work Environment Assessment. |
The article about transformational leadership explains how nurse leaders can inspire and encourage other employees to create change, which leads to the overall growth of the organization (Clark, 2015). Clark et al. (2011) describe how the leaders can cultivate the culture of civility in the workplace environment through fair treatment and respecting the employees. Similarly, Griffin and Clark (2014) highlight some of the intervention measures to curb incivility in the workplace. This article describes how violence can contribute to incivility and how to control it.
The theory described in the articles relates to the results I obtained for my workplace environment. Firstly, my workplace environment scored highly due to the presence of transformational leaders who inspire and cultivate the culture of civility. Secondly, workplace violence is minimized through conflict resolution and transparent communication.
|
| Explain how your organization could apply the theory highlighted in your selected article(s) to improve organizational health and/or create stronger work teams. Be specific and provide examples. | My workplace environment can use the theories in the articles above to improve the health of the organization by employing transformational leadership skills and resolving conflicts amicably. For example, my organization can achieve high retention of employees through the provision of competitive remuneration packages. |
| General Notes/Comments | Workplace civility is essential for the overall health of the organization. It is essential to assess the civility regularly and improve on the areas that might cause incivility. |
References
Clark, C. M. (2015). Conversations to inspire and promote a more civil workplace. Am Nurs Today, 10.
Clark, C. M., Olender, L., Cardoni, C., & Kenski, D. (2011). Fostering civility in nursing education and practice: Nurse leader perspectives. JONA: The Journal of Nursing Administration, 41(7/8), 324-330.
Griffin, M., & Clark, C. M. (2014). Revisiting cognitive rehearsal as an intervention against incivility and lateral violence in nursing: 10 years later. The Journal of Continuing Education in Nursing, 45(12), 535-542.
By Day 3 of Week 7
Post a brief description of the results of your Work Environment Assessment. Based on the results, how civil is your workplace? Explain why your workplace is or is not civil. Then, describe a situation where you have experienced incivility in the workplace. How was this addressed? Be specific and provide examples.
By Day 6 of Week 7
Respond to at least two of your colleagues on two different days by sharing ideas for how shortcomings discovered in their evaluations and/or their examples of incivility could have been managed more effectively.
Submission and Grading Information
Grading Criteria
To access your rubric:
Week 7 Discussion Rubric
Post by Day 3 and Respond by Day 6 of Week 7
To participate in this Discussion:
Week 7 Discussion
Assignment: Workplace Environment Assessment
Clearly, diagnosis is a critical aspect of healthcare. However, the ultimate purpose of a diagnosis is the development and application of a series of treatments or protocols. Isolated recognition of a health issue does little to resolve it.
In this module’s Discussion, you applied the Clark Healthy Workplace Inventory to diagnose potential problems with the civility of your organization. In this Portfolio Assignment, you will continue to analyze the results and apply published research to the development of a proposed treatment for any issues uncovered by the assessment.
To Prepare:
- Review the Resources and examine the Clark Healthy Workplace Inventory, found on page 20 of Clark (2015).
- Review the Work Environment Assessment Template.
- Reflect on the output of your Discussion post regarding your evaluation of workplace civility and the feedback received from colleagues.
- Select and review one or more of the following articles found in the Resources:
- Clark, Olender, Cardoni, and Kenski (2011)
- Clark (2018)
- Clark (2015)
- Griffin and Clark (2014)
The Assignment (3-6 pages total):
Part 1: Work Environment Assessment (1-2 pages)
- Review the Work Environment Assessment Template you completed for this Module’s Discussion.
- Describe the results of the Work Environment Assessment you completed on your workplace.
- Identify two things that surprised you about the results and one idea you believed prior to conducting the Assessment that was confirmed.
- Explain what the results of the Assessment suggest about the health and civility of your workplace.
Part 2: Reviewing the Literature (1-2 pages)
- Briefly describe the theory or concept presented in the article(s) you selected.
- Explain how the theory or concept presented in the article(s) relates to the results of your Work Environment Assessment.
- Explain how your organization could apply the theory highlighted in your selected article(s) to improve organizational health and/or create stronger work teams. Be specific and provide examples.
Part 3: Evidence-Based Strategies to Create High-Performance Interprofessional Teams (1–2 pages)
- Recommend at least two strategies, supported in the literature, that can be implemented to address any shortcomings revealed in your Work Environment Assessment.
- Recommend at least two strategies that can be implemented to bolster successful practices revealed in your Work Environment Assessment.
Sample Paper – Week 9 Assignment
NURS 6053 – Workplace Environment Assessment
Workplace Environment Assessment
Name of Student
Walden University
NURS 6053
Interprofessional Organization & System Leadership
Dr. Elvira G. Phelps
(Due date)
Workplace Environment Assessment
Incivility is a well-recognized and common issue in clinical practice as well as nursing education. As a contrast to civility, which involves considerate and respectful participation, incivility is referred to as low-intensity behavior characterized by various behaviors like being rude, impolite, or discourteous. It can be bidirectional and take many forms. It can occur between nurses, subordinates, and those in positions of leadership as well as from leaders to nurses in lower-ranking positions. Incivility in the healthcare workplace can involve repeated disrespectful, offensive, or discouraging behavior, unfair punishments, and misuse of power that can discourage and distress receivers. It ultimately creates strain and decreases the satisfaction and confidence of employees (Raheem & Cosby, 2016). This paper aims to describe the results of the Work Environment Assessment completed for my workplace and explain what they suggest about the civility and health of the workplace. It will also reveal a theory relating to the results and how the organization can apply it to create stronger work teams and improve organizational health. Strategies from the literature that can be implemented to bolster successful practices and address shortcomings revealed in the assessment will also be recommended.
Work Environment Assessment
The overall civility score of the workplace was 56, which falls in the unhealthy score range from 50 to 59 (Clark, 2015). Two surprising things were the statements; “communication at all levels of the organization is transparent, direct, and respectful.” and “teamwork and collaboration are promoted and evident,” which had deficient scores. It can be the cause of the exceptionally high turnover, especially among registered nurses within the department, as well as decreased job satisfaction scores and retention rates. An unhealthy and uncivil work environment can negatively influence staff commitment to the organization as well as their productivity. While working on the floor, there have been experiences of miscommunication, especially in changes in shifts. One scenario that portrays the issue involved hurrying up to get patient reports and stabilize another one as an intensive care unit (ICU) patient was waiting to transfer to the floor. My work phone was frequently ringing as the ICU nurse tried to give me a report. She eventually rolled the new patient to my level and expected a report right away as she had to go home. She was uncivil as I tried to apologize, and she responded, saying, “whatever, I don’t have time for this. I want to go home.” I respectfully acknowledged her incontinence that I might have caused, but my patient’s safety was my priority. Additionally, I explained to her that she needed to address me respectfully as we are both professionals, and the wellbeing of our patients comes first. One prior belief that was confirmed by the results is that the only thing helping the organization retain staff is the benefits and competitive salaries. The statement “the organization provides competitive salaries, benefits, compensations…” had the highest score in the assessment.
The results of the assessment suggest that the workplace is unhealthy and uncivil. Communication is lacking, and this impacts the health of the organization while the lack of teamwork harms the work environment. Broome and Marshall (2017) point out that communication and teamwork are among the critically essential core values for successful collaboration that shapes the quality of care for patients and families. Effective collaboration is not only personally and professionally satisfying to those involved, but also contributes to a unified and holistic approach to patients and clients, facilitates faster internal decision making, reduces cost through shared resources and promotes innovation. Healthcare professionals are socialized and educated in discipline-specific frameworks. They must move out of such habits for them to work together, and this requires sensitivity to other theoretical foundations as well as ways of thinking and knowing.
Review of Literature
Many studies have been conducted to establish the best evidence that can guide practice to decrease and address incivility in the workplace. One of the articles reviewed was titled “Revisiting cognitive rehearsal as an intervention against incivility and lateral violence in nursing: 10 years later” by Martha Griffin, and Cynthia Clark (2014). The authors had the aim of conducting a literature update on cognitive rehearsal, and they undertook reviews on the utilization of cognitive rehearsal as a strategy that is based on evidence for addressing bullying behaviors as well as incivility in nursing. Griffin and Clark (2014) point out that different kinds of negative interactions and behaviors occur between and among nurses and other care providers, including workplace mobbing, bullying, lateral violence, and incivility. Those in a higher power and authoritarian positions, including experienced nurses, managers, and physicians often present such behaviors. Many times the receiver’s or those impacted by incivility fail to address the offenders and often wish they could.
The authors describe the cognitive rehearsal concept as productive communication activities that can be utilized by individuals in addressing lateral violence and incivility by delivering the message that it is not okay to act in an uncivil or violent manner. Examples of disrespectful behavior are provided in the study as well as the cognitive rehearsal responses that can be utilized by healthcare professionals like nurses to practice rehearsing. They argue that even though the technique can be challenging to practice, it can effectively eliminate or reduce lateral violence and incivility. According to the authors, when incivility victims implement strategies from cognitive rehearsal, such behaviors can be removed. Clark (2015) supports this view by noting that the most effective way of addressing incivility is through speaking up when it happens. The author also advocates for the use of cognitive rehearsal in challenging conversations that aim to address incivility through three process steps. They include interactive and didactic instruction and learning, repetition of particular phrases to utilize in uncivil encounters, and sessions of practice for reinforcing instructions and rehearsal.
The concept of cognitive rehearsal relates to the results of the workplace assessment as it addresses the issues of communication and teamwork. The workplace scored very low on these domains, meaning it is unhealthy and uncivil. Clark (2015) points out that utilization of cognitive rehearsal can enable improved communications, greater nurse satisfaction, and a workforce that is more conflict-capable as well as improved patient care. One model proposed to address incivility under this concept is the DESC model. It stands for Describe, Express, State, and Consequences. The organization can apply it to create a healthier organization as well as stronger working teams. The model is part of an evidence-based teamwork system for improving communication and teamwork skills, which in turn improves on the quality of care and safety. The model will help professionally address uncivil behavior to help relieve stress and conflict within the work environment. That means, respectfully confronting and having a conversation with the uncivil coworker.
An example can include the uncivil ICU nurse in a hurry to get home during shift changing. Describing can involve explaining that you understand she is in a hurry and apologizing for delaying, although you feel she is not giving enough information. Explaining can involve telling her she is disrespectful to a colleague. Stating can include providing an alternative like giving more information or talking with respect and decency. At the same time, consequences can involve explaining how her behavior can result in information breakdown that can harm the patient’s safety.
Evidence-Based Strategies to Create High-Performance Inter-professional Teams
Strategies to Address Shortcomings
Strategies that can be applied in addressing the shortcomings of poor communication and teamwork involve reflection, probing, and commitment. Clark (2015) points out that reflection on our workplace cultures, as well as the interactions and relationships we have with others is a vital step toward the improvement of team, individual, and organization success. Fundamental questions have to be asked when one is faced with the prospect of having a challenging conversation. They include inquiring about what would happen if one engages in a difficult conversation as well as what would happen if they did not. It also includes asking oneself what would happen to the patient if they stayed silent. Not speaking up during disrespectful situations has been identified as a severe breakdown of communication among care providers, and it has been asserted that such failures can have severe consequences for patient care. Creating commitment to a practice of speaking up can involve multifaceted organization approaches which foster a culture where individuals can effectively speak up when they have concerns.
Various sources of influence, as well as recommendations, can be utilized, such as improving the ability of everyone to speak and hold their colleagues accountable to safe practices. Such skills can be acquired through training and education, development of scripts, role-playing, as well as the increased practice of communication skills in situations involving high stakes. Also, the DESC framework can be applied in uncivil scenarios to structure conversations that are based on civility. Clark (2015) notes that utilizing the cognitive rehearsal strategies in combination with the DESC model is an effective means of addressing particular incidents of incivility.
Strategies to Bolster Successful Practices
The workplace assessment revealed one successful practice where the organization provides competitive compensations, benefits and salaries. It can be boosted further through the involvement of all stakeholders in the decision making processes of the organization. It involves incorporating team members from all care levels in creating and sharing the goals, values, and mission of the organization. Happy employees have been described as those whose personal values or visions align with those of the organization (Black and Venture, 2017). The goal, value, and mission of respect and civility should be embraced and shared by everyone in the organization to ensure its success. Employees at all levels need to be part of what the organization seeks to achieve so they can align their behavior towards the shared objectives. The second strategy involves effectively clarifying expectations about the clinical practice to enhance workplace autonomy. Such an approach can enable nurses to organize their work and communicate more effectively to promote sound clinical decisions (Griffin & Clark, 2014). Effective communication is necessary to ensure clarity, especially between leaders and subordinates. Every employee needs to know what they are expected to achieve or do and how they can accomplish it, and this includes the type of behavior that should be practiced in the organization.
Conclusion
Workplace incivility negatively influences employees as well as the health of the organization with communication and inter-professional teamwork being greatly affected. Literature points to various evidence-based strategies for reducing and eliminating incivility including reflection on our workplace cultures, as well as the interactions and relationships. It also points to the involvement of all stakeholders in the decision making processes of the organization to bolster successful practices.
References
Black, J., & Venture, K. L. (2017). The human factor to profitability: People-centered cultures as meaningful organizations. Journal of Organizational Psychology, 17(2), 24-34.
Broome, M. E., & Marshall, E. S. (2017). Collaborative Leadership Contexts: Networks, Communication, Decision Making, and Motivation. Transformational Leadership in Nursing: From Expert Clinician to Influential Leader, 86.
Clark, C. M. (2015). Conversations to inspire and promote a more civil workplace. American Nurse Today, 10(11), 18-23.
Griffin, M., & Clark, C. M. (2014). Revisiting cognitive rehearsal as an intervention against incivility and lateral violence in nursing: 10 years later. The Journal of Continuing Education in Nursing, 45(12), 535-542.
Rahim, A. and Cosby, D. (2016), “A model of workplace incivility, job burnout, turnover intentions, and job performance”, Journal of Management Development, Vol. 35 No. 10, pp. 1255-1265. https://doi.org/10.1108/JMD-09-2015-0138
By Day 7 of Week 9
Submit your Workplace Environment Assessment Assignment.
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
- Please save your Assignment using the naming convention “WK9Assgn+last name+first initial.(extension)” as the name.
- Click the Week 9 Assignment Rubric to review the Grading Criteria for the Assignment.
- Click the Week 9 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
- Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK9Assgn+last name+first initial.(extension)” and click Open.
- If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
- Click on the Submit button to complete your submission.
Grading Criteria
To access your rubric:
Week 9 Assignment Rubric
Check Your Assignment Draft for Authenticity
To check your Assignment draft for authenticity:
Submit your Week 9 Assignment draft and review the originality report.
Submit Your Assignment by Day 7 of Week 9
To submit your Assignment:
Week 9 Assignment
Next Module
To go to the next Module:
Module 5
Module 5: Organizational Change (Weeks 10-11)
Laureate Education (Producer). (2018). Forecasting Organizational Change [Video file]. Baltimore, MD: Author.
Learning Objectives
Students will:
- Recommend strategies to lead organizational change
- Justify plans for implementing and managing organizational change in organizational/workplace settings
- Create plans for communicating proposed changes to stakeholders
- Recommend risk mitigation plans when managing organizational changes
| Due By | Assignment |
| Week 10, Days 1–7 | Read the Learning Resources. Begin to compose your Assignment. |
| Week 11, Day 1 | Continue to compose your Assignment. |
| Week 11, Day 2 | Deadline to submit your Assignment. |
Learning Resources
Required Readings
Marshall, E., & Broome, M. (2017). Transformational leadership in nursing: From expert clinician to influential leader (2nd ed.). New York, NY: Springer.
- Chapter 8, “Practice Model Design, Implementation, and Evaluation” (pp. 195–246)
Cullen, L., & Adams, S. L. (2012). Planning for implementation of evidence-based practice. Journal of Nursing Administration, 42(4), 222–230. Retrieved from https://medcom.uiowa.edu/annsblog/wp-content/uploads/2012/10/JONA-FINAL-Cullen-2012.pdf
Pollack, J., & Pollack, R. (2015). Using Kotter’s eight stage process to manage an organizational change program: Presentation and practice. Systemic Practice and Action Research, 28(1), 51-66.
Note: You will access this article from the Walden Library databases.
Seijts, G. H., & Gandz, J. (2016). Transformational change and leader character. Business Horizons, 61(2), 239-249. https://doi.org/10.1016/j.bushor.2017.11.005
Note: You will access this article from the Walden Library databases.
Tistad, M., Palmcrantz, S., Wallin, L., Ehrenberg, A., Olsson, C. B., Tomson, G., …Eldh, A. C. (2016). Developing leadership in managers to facilitate the implementation of national guideline recommendations: A process evaluation of feasibility and usefulness. International Journal of Health Policy and Management, 5(8), 477–486. doi:10.15171/ijhpm.2016.35. Retrieved from http://www.ijhpm.com/article_3183_5015382bcf9183a74ef7e79b0a941f65.pdf
Required Media
TEDx. (2013, January). Six keys to leading positive change: Rosabeth Moss Kanter at TEDxBeaconStreet [Video file]. Retrieved from https://www.youtube.com/watch?v=owU5aTNPJbs
Assignment: Change Implementation and Management Plan
It is one of the most cliché of clichés, but it nevertheless rings true: The only constant is change. As a nursing professional, you are no doubt aware that success in the healthcare field requires the ability to adapt to change, as the pace of change in healthcare may be without rival.
As a professional, you will be called upon to share expertise, inform, educate, and advocate. Your efforts in these areas can help lead others through change. In this Assignment, you will propose a change within your organization and present a comprehensive plan to implement the change you propose.
To Prepare:
- Review the Resources and identify one change that you believe is called for in your organization/workplace.
- This may be a change necessary to effectively address one or more of the issues you addressed in the Workplace Environment Assessment you submitted in Module 4. It may also be a change in response to something not addressed in your previous efforts. It may be beneficial to discuss your ideas with your organizational leadership and/or colleagues to help identify and vet these ideas.
- Reflect on how you might implement this change and how you might communicate this change to organizational leadership.
Week 11
The Assignment (5-6-minute narrated PowerPoint presentation):
Change Implementation and Management Plan
Create a narrated PowerPoint presentation of 5 or 6 slides with video that presents a comprehensive plan to implement the change you propose.
Your narrated presentation should be 5–6 minutes in length.
Your Change Implementation and Management Plan should include the following:
- An executive summary of the issues that are currently affecting your organization/workplace (This can include the work you completed in your Workplace Environment Assessment previously submitted, if relevant.)
- A description of the change being proposed
- Justifications for the change, including why addressing it will have a positive impact on your organization/workplace
- Details about the type and scope of the proposed change
- Identification of the stakeholders impacted by the change
- Identification of a change management team (by title/role)
- A plan for communicating the change you propose
- A description of risk mitigation plans you would recommend to address the risks anticipated by the change you propose
Sample Paper – Week 11 Assignment
NURS 6053 – Change Implementation and Management Plan
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By Day 2 of Week 11
Submit your narrated Change Implementation and Management Plan.
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
- Please save your Assignment using the naming convention “WK11Assgn+last name+first initial.(extension)” as the name.
- Click the Week 11 Assignment Rubric to review the Grading Criteria for the Assignment.
- Click the Week 11 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
- Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK11Assgn+last name+first initial.(extension)” and click Open.
- If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
- Click on the Submit button to complete your submission.
Grading Criteria
To access your rubric:
Week 11 Assignment Rubric
Check Your Assignment Draft for Authenticity
To check your Assignment draft for authenticity:
Submit your Week 11 Assignment draft and review the originality report.
Submit Your Assignment by Day 2 of Week 11
To submit your Assignment:
Week 11 Assignment
Congratulations! After you have finished all of the assignments for this Module, you have completed the course. Please submit your Course Evaluation by Day 7.
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