Leadership
philosophy
"we believe that"
7 steps to problem solving
1. problem recognition 2. gather info 3. Goal definition 4. Goal selection 5. consider negatives 6. Make decision 7. Implement and evaluate
transactional leader
A leader who is concerned with accomplishing the group's tasks, getting group members to do their jobs, and making certain that the group achieves its goals.
collaboration and consultation
A model that emphasizes a close working relationship between general and special educators.
functional nursing
A nursing care pattern focusing on tasks and jobs; each nursing team member has certain tasks and jobs to do
Transforming Care at the Bedside (TCAB)
A program of the Institute for Healthcare Improvement designed to improve care of patients
Authentic Leadership
A style in which the leader is true to himself or herself while leading
Activist follower
Activate change
ANCC
American Nurses Credentialing Center
AONE
American Organization of Nurse Executives
DECIDE model
Define problem Explore alternatives Consider consequences Identify values Decide and act Evaluate results
Banghbanian's environmental model
Epical criteria, economic criteria, clinical criteria, and institutional criteria
situational theory of leadership
Extension of behavioral theories Focus on characteristics of followers Seek appropriate leadership behavior Leadership is based on relationship with followers and readiness level of followers
innovators
First adopters of new products
Diehard follower
Goes above and beyond
case management nursing
Growing field in nursing developed as a way of managing health care costs and patient length of stay; Involves systematic collaboration with patients, their significant others, and their health care providers to coordinate high-quality health care services in a cost effective manner with positive patient outcomes
current issues and trends Mission statement
IHI Triple Aim ACA IOM's goal ANCC magnet
IHI Triple Aim
Improve the patient experience of care (including quality and satisfaction) Improve the health of populations. Reduce the per capita cost of health care.
IOM
Institute of Medicine
clinical leadership
Instrumental and interpersonal support provided by those who hold clinical positions, such as physicians and nurses
Tanner's Clinical Judgement Model
Noticing Interpreting Responding Reflecting
private duty nursing
One-on-one care when a child or adult is impaired by a catastrophic event or chronic illness. Usually not covered by insurance
early adopters
People who adopt new products early, choose new products carefully, and are viewed as "the people to check with" by later adopters
Structured Care Methodologies
Procedure: set of how-to action steps Standard of care: description of acceptable level of patient care Algorithm: set of steps used to make a decision Clinical practice guideline: statement outlining appropriate practice for clinical condition or procedure
QSEN
Quality and Safety Education for Nurses
complexity theory
Requires leaders to expand and respond to engaging dynamic change and focus on relationships rather than on prescribing and approaching change as a lock-step, pre-prescribed method. Traditional organizational hierarchy plays a less significant role as the "keeper of high level knowledge" and replaces it with the idea that knowledge applied to complex problems is better distributed among the human assets within an organization, without regard to hierarchy. Leaders try less to control the future and spend more time influencing, innovating, and responding to the many factors that influence health care.
vestal's global model
She stated that the first step in decision making is to ask how one can make a situation better—or what the problem is—and who can assist in the decision-making process. So next desired outcomes are defined with the help of a team. Brainstorming occurs to come up with potential solutions. the implications and consequences of the course of action must be analyzed. the best solution is chosen. An implementation plan is outlined, and outcome criteria are identified. Thus the final step in Vestal's model is to present the solution in a concise manner to the next level in the organization.
quantum leadership
States that leaders must work together with subordinates to identify common goals, exploit opportunities, and empower staff to make decisions for organizational productivity to occur
chaos theory
States that variation is a normal part of managing health care systems. Attempts to account for the complexity and randomness in organizations. It suggests that a degree of order can be attained by viewing complicated behaviors and situations as predictable (expect the unexpected).
SOAR
Strengths, Opportunities, Aspirations, Results
data analytics
The science of examining raw data with the purpose of drawing conclusions about that information
critical pathways
Tools used in managed care that incorporate the treatment interventions of caregivers from all disciplines who normally care for a patient. Designed for a specific care type, a pathway is used to manage the care of a patient throughout a projected length of stay.
systems theory of management
Views the organization as a set of interdependent parts that together form a whole Provides nurse managers with a framework to view nursing services as a subsystem of a larger organization There is interrelatedness and interdependence amongst all parts of the health care organization Open systems function better than closed systems.
model the way
What principle of leadership is about earning the right and the respect to lead through direct involvement and action; students must follow first the person, then the plan?
order set
a grouping of treatment options for a specific diagnosis or condition; predefined groupings of standard orders for a condition, disease, or procedure
transformational leader
a leader who is able to instill in the members of a group a sense of mission or higher purpose, thereby changing the nature of the group itself
contingency theory
a leadership theory that states that in order to maximize work group performance, leaders must be matched to the situation that best fits their leadership style
shared governance
a method that aims to distribute decision making among a group of people
primary nursing
a nursing care pattern; an RN is responsible for the person's total care
Strategic Management
a process that involves managers from all parts of the organization in the formulation and the implementation of strategies and strategic goals
what makes a great leader
ability to engage others in shared meaning distinctive and compelling vocal tone sense of integrity hardiness and ability to grasp context
provide support during change
active listening promote action steps and solutions keep staff informed ask for input refraining difficult messages
Participant Followers
actively participates whether they want to do or not
followership
allowing people to follow and learn
leader as change agent
articulate need group participation through leaving details to unit get reliable info to implementer motivate with reward no false promises
attitudinal theory of nursing
attitude makes a leader
two basic nursing roles
care provider care coordinator/integrators
rapid cycle change
change due to acute changes
collecting phase
collect data
Nurse executive competencies
communication and relation management leadership business skills knowledge of healthcare professionalism
organized abandonment
company starts distancing themselves from product ex: use of photo film
decision support systems
computer software systems designed to help managers solve problems by showing how results vary when the manager alters assumptions or data
feminist leadership
concern for family, relationships, community
clinical judgement
conclusions and opinions about patients health drawn from patient data
laggards
consumers who like to avoid change and rely on traditional products until they are no longer available
directing phases
coordinate motivate train
scripting
creating a list of instructions and commands
decision making will involve
creativity innovation quality safety controlling costs
major areas of change influencing health care today
customer preventative cost interdependence continuity of info
unilateral decision
decision made by only one person or group of people without taking others' opinion into consideration
managerial skills
develop peer relationship negotiate motivate resolve conflicts establish networks make vague decisions allocate resources
three skills of leaders
diagnosing adapting communicating
strategies for decision making
direct intervention indirect intervention watchful waiting collaboration and consultation facilitation modeling informatics cognitive work flow analysis
direct intervention
do it yourself
clinical decision making
documentation medication administation IV med delivery Triage decisions Prioritization
strategic plan document sections
executive summary background mission. vision, values goals appendiges
change management
executives initiate change, but don't cause direct change recipients change and translate plan informal communication senior management monitors attention given at discussions mediators occur change ambassadors used senior managers live the change
facilitation
get people on board
Situational Leadership
groups move back and fourth through phases, leadership changes based on group's needs
adaptive capacity
hardiness and ability to grasp context
Culture-climate link
he common links between culture and climate can be described as the interaction of shared values about what things are important, beliefs about how things work, and behaviors about how things get done
caring values are reflective of
how they treat staff
phases of planning
identify mission conduct environmental scan analyze situation establish goals identify strategies set objectives assign responsibilities and timeline write planning doc celebrate
early majority
individuals who adopt a new product just prior to the average person
patient safety culture
involvement blameless communication teamwork belief about errors
Complexity Leadership Theory
key is to effectively combine bureaucratic organizing with complex adaptive systems. Recognizes 3 types of leadership systems in organizations: -administrative leadership -entrepreneurial leadership -adaptive leadership
Roger's innovation theory
knowledge persuasion decision implementation of new idea confirmation or stopping
Trait Theory of Leadership
leadership depends on the personal qualities or traits of the leader
three contemporary trends
magnet professional practice patient safety
team nursing
method of care in which a nurse acts as a leader of a group of people giving care
modeling
modeling to have people follow
strengths in environment related to
operations management products finances
changes in nursing
organizational structure nursing labor force reimbursement information system
management process
planning, organizing, leading, controlling
trans stages of change
precontemplation contemplation prep action maintenance
Servant Leadership Theory
proposes that a person is a servant to others first and makes a conscious decision to lead in order to better serve others, not to increase power.
5 managerial mindsets
reflective (manage self) analytic (organization) Worldly (context) Collaborative (relationships) Action (managing change)
clinical reasoning
reflective, concurrent and creative thinking about patients and patient care
determinants of successful planned change
relative advantage compatibility complexity trial-ability observability
Managerial decision making
resources such as financial, ethical, human
ethical resource decision
right people right time
indirect intervention
seek outside source
four skills sets of GOOD leaders
self-aware self management social awareness relationship management
Decision making tools
shared governance evidence-informed decision making Pilot projects simulation data analytics decision support systems SBAR
SWOT
strengths, weaknesses, opportunities, threats
Leader Effectiveness Model
task behavior behavior four basic leadership styles effectiveness readiness
late majority
the last group of buyers to enter a new product market; when they do, the product has achieved its full market potential
Strategic Planning
the process of developing and maintaining a strategic fit between the organization's goals and capabilities and its changing marketing opportunities
tactical planning
the process of developing detailed, short-term statements about what is to be done, who is to do it, and how it is to be done
organizational culture
the set of values, ideas, attitudes, and norms of behavior that is learned and shared among the members of an organization
organizational climate
the shared perceptions organizational members have about their organization and work environment
Isolate Followers
they won't follow and so they isolate
three elements of successful change
unfreeze moving refreeze
Bystander followers
very good follower because they stand back and assess situation
watchful waiting
wait to say anything
eight practices for executives
what needs to be done what is right for company action plan development take responsibility communicate opportunity focus productive meetings say We not I
characteristics of nurse innovators
willing to take risks question beliefs knowledgeable expert comfort with failure ability professional networker
phases of organization
work people environment
Magnet Hospitals
• Recognized by ANCC • Measure the strength and quality of nursing • Where nursing delivers excellent patient outcomes, have a high level of job satisfaction, low staff nurse turnover, appropriate grievance resolution • Indicated nursing involvement in data collection and decision making in patient care • Value staff nurses