Leadership Quiz 1 Vocab

Case manager

A baccalaureate degree- or master's degree-prepared clinical nurse who coordinates patient care from preadmission through discharge. (Ch. 13)

Organizational chart

A chart that defines organizational positions' responsibility for specific functions. (Ch. 8)

High-complexity change

A complicated change situation characterized by the interactions of multiple variables of people, technology, and systems. (Ch. 17)

Critical path/critical pathway

A component of a care MAP that is specific to diagnosis-related group reimbursement. The purpose is to ensure patients are discharged before insurance reimbursement is eliminated. (Ch. 13)

Critical thinking

A composite of knowledge, attitudes, and skills; an intellectually disciplined process. Also, the ability to assess a situation by asking open-ended questions about the facts and assumptions that underlie it and to use personal judgment and problem-solving ability in deciding how to deal with it. (Ch. 6)

Cultural marginality

A condition of bordering on one or more cultures and perceiving no membership or affiliation with either. (Ch. 9)

Magnet™ recognition

A distinction granted by the American Nurses Credentialing Center for quality nursing services. (Ch. 1)

Respondeat superior

A doctrine by which the employer is given accountability and responsibility for an employee's negligent actions incurred during the course and scope of employment. (Ch. 5)

Shared governance

A flat type of organizational structure with decision making decentralized. (Chs. 8, 19)

Role theory

A framework used to understand how individuals perform within organizations. (Chs. 4, 15)

Line function

A function that involves direct responsibility for accomplishing the objectives of a nursing department, service, or unit. (Ch. 8)

Consolidated systems

A group of healthcare organizations that are united based on common characteristics of ownership, regional location, or mutual performance objectives for the purpose of optimizing utilization of their resources in achieving their missions. (Ch. 7)

System

A group or organization working together as a unified whole. (Ch. 8)

Democratic

A leadership style that places control within the group at large where shared authority leads to decisions. (Ch. 6)

Associate nurse

A licensed nurse in the primary care model who provides care to the patient according to the primary nurse's specification when the primary nurse is not working. (Ch. 13)

National Quality Forum (NQF)

A membership-based organization that sets priorities and goals for performance improvement and endorses standards for measurement. (Ch. 2)

Functional model of nursing

A method of providing patient care by which each licensed and unlicensed staff member performs specific tasks for a large group of patients. (Ch. 13)

Partnership model

A method of providing patient care when an RN is paired with an LPN/LVN or an unlicensed assistive person to provide total care to a number of patients. (Ch. 13)

Patient-focused care

A model in which staff functions become centralized on a unit to reduce the number of staff required; emphasizes quality, cost, and value. (Ch. 13)

Synergy Model

A model of care delivery adopted by the American Association of Critical-Care Nurses that matches the needs and characteristics of the patient with the competencies of the nurse. Seven characteristics are unique to every patient, and each nurse has varying levels of ability, which are categorized into eight competencies. When the knowledge, skills, and competencies of the nurse are utilized to meet the complex needs of the patient and family, the care is optimal. (Ch. 13)

Case method

A model of care delivery in which one nurse provides total care for a patient during an entire work period. (Ch. 13) Clinical nurse leader

Differentiated nursing practice

A model of care that recognizes the difference in the level of education and competency of each registered nurse. The differentiation is based on education, position, and clinical expertise. (Ch. 13)

Case-management model

A model of delivering patient care based on patient outcomes and cost containment. Components of case management are a case manager, critical paths/critical pathways, and unit-based managed care. (Ch. 13)

Primary nursing

A model of patient care delivery whereby one registered nurse functions autonomously as the patient's main nurse throughout the entire hospital stay. (Ch. 13)

Case management

A person-oriented service that reflects multidisciplinary cooperation and coordination. (Ch. 4)

Quantum theory

A physics theory stating that energy is not a smooth-flowing continuum but, rather, bursts of energy that are related. (Ch. 4)

Transforming Care at the Bedside (TCAB)

A program of the Institute for Healthcare Improvement designed to improve care of patients. (Ch. 13)

Licensure

A right granted that gives the licensee permission to do something that he or she could not legally do absent such permission; the minimum form of credentialing, providing baseline expectations for those in a particular field without identifying or obligating the practitioner to function in a professional manner as defined by the profession itself. (Chs. 5, 29)

Team nursing

A small group of licensed and unlicensed personnel, with a team leader, responsible for providing patient care to a group of patients. (Ch. 13)

Fee-for-service

A system in which patients have the option of consulting any healthcare provider, subject to reasonable requirements that may include utilization review and prior approval for certain services but does not include a requirement to seek approval through a gatekeeper. (Ch. 7)

Reengineering

A total reorganization of how an organization will function, with the goal of increased efficiency. (Ch. 8)

Moral distress

A type of distress that occurs when faced with situations in which two ethical principles compete, such as when the nurse is balancing the patient's autonomy issues with attempting to do what the nurse knows is in the patient's best interest. Moral distress may occur also when the nurse manager is balancing a staff nurse's autonomy with what the nurse manager perceives to be a better solution to an ethical dilemma. (Ch. 5)

Service-line structures

A type of structure in which the functions necessary to produce a specific service or product are brought together into an integrated organizational unit under the control of a single manager or executive. (Ch. 8)

Culture

A way of life conveyed strongly enough for a group of people to describe its meaning. It consists of values, beliefs, attitudes, practices, rituals, and traditions. (Chs. 9, 19)

Team STEPPS

AHRQ strategy to promote patient safety

Vertical integration

Alignment of orgs to provide a full array or continuum of services. (Ch. 7)

Teaching institution

An academic health center and affiliated hospital. (Ch. 7

Transformational leadership

An act of encouraging followers to follow the leader's style and change their interests into a group interest with concern for a broader goal. (Ch. 3)

Ethnicity

An affiliation with a group often based on race or language. (Ch. 9)

Systems theory

An approach to consider how various independent parts interact to form a unified whole or to disrupt a unified whole; the construct related to the operation of the whole process or entity. (Ch. 8)

Autocratic

An authoritarian style that places control within one person's position. (Ch. 6)

Clinical nurse leader

An evolving role of the professional nurse being developed by the American Association of Colleges of Nursing (AACN). (Ch. 13)

Tacit knowledge

An implied, unspoken knowledge (Ch. 1)

Institute for Healthcare Improvement (IHI)

An independent organization devoted to improving patient safety and health care globally. (Ch. 2)

Health literacy

An individual's capacity to obtain, process, and understand health information needed to make appropriate health decisions. (Chs. 5, 22)

Joint Commission, The

An organization that accredits healthcare organizations and is deemed by the Center for Medicare & Medicaid Services (CMS) as holding healthcare facilities to CMS standards. (Ch. 2)

Institute of Medicine (IOM)

An organization that works outside of the federal government to provide independent, scientific advice. (Ch. 2)

For-profit organization

An organization, such as a hospital, that is operated to create excess income (profit) for the benefit of owners or stockholders. (Ch. 7)

Matrix structure

An organizational structure influenced by dual authority, such as product line and discipline. (Ch. 8)

Low-complexity change

An uncomplicated change situation characterized by the interactions of the limited influences of people, technology, and systems. (Ch. 17)

Variance

Anything that alters a patient's progress through a normal care path. (Chs. 12, 13)

Strategies

Approaches designed to achieve a specific purpose. (Ch. 17)

Functional structure

Arrangement of departments and services by specialties. (Ch. 8)

Informed consent

Authorization by patient or patient's legal representative to do something to the patient. (Ch. 5)

Transculturalism

Bridging significant differences in cultural practices. (Ch. 9)

Cultural sensitivity

Capacity to feel, convey, and react to ideas, habits, customs, or traditions unique to a group of people. (Ch. 9)

Managed care

Care purchased through a public or private healthcare organization whose goal is to promote quality healthcare outcomes for patients at the lowest cost possible through planning, directing, and coordinating care delivered by healthcare organizations that it may own, have contractual agreements with, or have authority over by virtue of the fact that it reimburses the organization for services provided its patients. This model rewards providers for low utilization of care that is relatively low in cost; also, a system of care in which a designated person determines the services the patient uses. (Chs. 4, 7, 12)

Hierarchy

Chain of command that connotes authority and responsibility. (Ch. 8)

Planned change

Change expected and deliberately prepared beforehand by using systematic directional processes to develop and carry out activities to accomplish a desired outcome. (Ch. 17)

Nonlinear change

Change occurring from self-organizing patterns, not human-induced ones, in complex, open-system organizations. (Ch. 17)

Flat organizational structure

Characterized by decentralization of decision making to the level of personnel carrying out the work. (Ch. 8)

Bureaucracy

Characterized by formality, low autonomy, a hierarchy of authority, an environment of rules, division of labor, specialization, centralization, and control. (Ch. 8)

Advanced generalist

Clinical nurse leader, which is a protected title for those who successfully complete the CNL certification examination. (Ch. 13)

Participative

Comparable to democratic style; involves others in making decisions. (Ch. 6)

Foreseeability

Concept that certain events may reasonably be expected to cause specific consequences; third element of negligence/malpractice. (Ch. 5)

Creativity

Conceptualizing new & innovative approaches to solving problems or making decisions. (Ch. 6)

Disease management

Continuous, coordinated processes to manage the progression of care over the course of a disease. (Ch. 13)

Learning organization

Designation of type of org. in which continual learning as an expectation permeates all levels to promote adequate responses required by dynamic, accelerated change. (Ch. 17)

Secondary care

Disease restorative care. (Ch. 7)

Apparent agency

Doctrine whereby a principal becomes accountable for the actions of his or her agent; created when a person holds himself or herself out as acting on behalf of the principal; also known as apparent authority. (Ch. 5)

Entrenched workforce

Employed persons older than 35 years who are thought of as the Baby Boomer generation. (Ch. 3)

Role

Expected or actual behavior, determined by a person's position or status in a group. (Ch. 4)

Barriers

Factors, internal or external to the change situation, that interfere with movement toward a desirable outcome. (Ch. 17)

Facilitators

Factors, internal or external to the change situation, that promote movement toward a desired outcome. (Ch. 17)

Malpractice

Failure of a professional person to act in accordance with the prevalent professional standards or failure to foresee potential consequences that a professional person, having the necessary skills and expertise to act in a professional manner, should foresee. (Ch. 5)

Negligence

Failure to exercise the degree of care that a person of ordinary prudence, based on the reasonable person standard, would exercise under the same or similar circumstances; also known as ordinary negligence. (Ch. 5)

Primary care

First access to care. (Ch. 7)

Staff function

Function that assists those in line positions in accomplishing primary objectives. (Ch. 8)

Ethics committee

Group of persons who provide structure and guidelines for potential healthcare problems, serve as an open forum for discussion, and function as patient advocates. (Ch. 5)

Unlicensed assistive personnel

Healthcare workers who are not licensed and who are prepared to provide certain elements of care under the supervision of a registered nurse (e.g., technicians, nurse aides, certified nursing assistants). (Ch. 13)

Vicarious liability

Imputation of accountability upon one person or entity for the actions of another person; substituted liability or imputed liability. (Ch. 5)

Change agents

Individuals with formal or informal legitimate power whose purpose is to initiate, champion, and direct or guide change. (Ch. 17)

Negative feedback

Information indicating a correction is needed. (Ch. 17)

Values

Inner forces that influence decision making and priority setting. (Ch. 1)

Fidelity

Keeping one's promises or commitments. (Ch. 5)

Nurse practice act

Legal scope of practice allowed by state legislation and authority. (Ch. 5)

Standard of care

Level of quality considered adequate by a profession; skills and learning commonly possessed by members of a profession; also written at a minimum level. (Ch. 5)

Multiculturalism

Maintaining several different cultures. (Ch. 9)

Quality indicators

Measurable elements of quality that specify the focus of evaluation and documentation. (Chs. 4, 22)

Collective bargaining

Mechanism for settling labor disputes by negotiation between the employer and representatives of the employees. (Chs. 5, 19)

Cross-culturalism

Mediating between and among cultures. (Ch. 9)

Emotional intelligence

Monitoring emotions in a situation to guide actions and inform thought processes. (Ch. 1)

DNV (Det Norske Veritas)

New deeming organization (2008) to accredit healthcare orgs. (Ch. 2)

Failure to warn

Newer area of potential liability for nurse managers that involves the responsibility to warn subsequent or potential employers of nurses' incompetence or impairment. (Ch. 5)

Indemnification

Obligation resting on one person to make good any loss or damages another has incurred because of the person's actions or inactions; refers to the total shifting of the economic loss to the party chiefly responsible for that loss. (Ch. 5)

Primary nurse

One who delivers autonomous care. (Ch. 13)

Independent contractor

One who makes an agreement with another to perform a service or piece of work and retains in himself or herself control of the means, method, and manner of producing the result to be accomplished; sometimes called an independent practitioner. (Ch. 5)

Private non-profit (or not-for-profit) organization

Organization that has funds redirected to maintenance and growth rather than as dividends to stockholders. (Ch. 7)

Follower

Person who contributes to a group's outcomes by implementing activities and providing appropriate feedback. (Ch. 4)

Leader

Person who demonstrates and exercises influence and power over others. (Ch. 4)

Informal change agent

Person without designated authority who advances the change among a group of people. (Ch. 17)

Emancipated minor

Person younger than adulthood who is no longer under the control and regulation of parents and who may give valid consent for medical procedures; examples include married teens, underage parents, and teens in the armed services. (Ch. 5)

Autonomy

Personal freedom and the right to choose what will happen to one's own person. (Ch. 5)

Hybrid

Possessing characteristics from several types of organizational structures. (Ch. 8)

Deeming authority

Power granted by one with power so that recipient acts in his or her place. (Ch. 7)

Paternalism

Principle that allows one to make decisions for another; often called parentalism. (Ch. 5)

Veracity

Principle that compels the truth be told completely. (Ch. 5)

Justice

Principle that persons should be treated equally and fairly. (Ch. 5)

Nonmaleficence

Principle that states that one should do no harm. (Ch. 5)

Beneficence

Principle that states that the actions one takes should promote good. (Ch. 5)

Third-party payers

Private and public agencies that contract with an individual to assume responsibility to pay under defined conditions for specified healthcare services. (Ch. 7)

Acculturation

Process by which a person becomes a competent participant in dominant culture. (Ch. 9)

Accreditation

Process by which an authoritative body determines that an organization meets certain standards to such a degree that the organization is able to meet the standards as a whole and without ongoing monitoring of each aspect of performance. (Ch. 7)

Nursing case management

Process of a nurse coordinating health care by planning, facilitating, and evaluating interventions across levels of care to achieve measurable cost and quality outcomes. (Ch. 13)

Public institution

Providing health services under the support and direction of local, state, or federal government. (Ch. 7)

Decision making

Purposeful and goal-directed effort using a systematic process to choose among options. (Ch. 6)

QSEN

Quality and Safety Education for Nurses

Liable

Refers to one's responsibility for his or her actions or inactions. (Ch. 5)

Liability

Refers to one's responsibility for his or her own conduct; an obligation or duty to be performed; responsibility for an action or outcome. (Ch. 5)

Cybernetic theory

Regulation of systems by managing communication and feedback mechanisms. (Ch. 17)

Tertiary care

Rehabilitative or long-term care. (Ch. 7)

Complexity theory

Require 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. (Ch. 1)

Networks

Resources of colleagues upon whom you can draw for advice; formal systems to provide services. (Ch. 7)

Statute

Rule/regulation created by elected legislative bodies; also known as statutory law. (Ch. 5)

Ethics

Science relating to moral actions and moral values; rules of conduct recognized in respect to a particular class of human actions. (Ch. 5)

Satisficing decision

Selecting an option that is acceptable but not necessarily the best option. (Satisfy + suffice = satisfice.) (Ch. 6)

Optimizing decision

Selecting the ideal solution or option to achieve goals. (Ch. 6)

Personal liability

Serves to make each person responsible at law for his or her own actions. (Ch. 5)

Mentor

Someone who models behavior, offers advice and criticism, and coaches the novice to develop a personal leadership style.

Law

Sum total of rules and regulations by which a society is governed; rules and regulations established and enforced by authority or custom within a given community, state, or nation. (Ch. 5)

Redesign

Technique to analyze tasks to improve efficiency. (Ch. 8)

Restructuring

Technique to enhance organizational productivity. (Ch. 8)

Transactional leadership

The act of using rewards and punishments as part of daily oversight of employees in seeking to get the group to accomplish a task. (Ch. 3)

Management

The activities needed to plan, organize, motivate, and control the human and material resources needed to achieve outcomes consistent with the organization's mission and purpose. (Chs. 1, 3)

Organizational culture

The attitudes, behaviors, and policies evident in an organization that create the ambiance and operation of the workplace. (Chs. 4, 8)

Corporate liability

The condition of being responsible for corporate loss related to acts performed and not performed in meeting obligations to operate legally and judiciously. (Ch. 5)

Cultural imposition

The condition that exists when one individual or organization attempts to require another individual or group to accept the values, attitudes, and beliefs of the first. (Ch. 9)

Horizontal integration

The condition that results when two (or more) organizations with similar services come together. (Ch. 7)

Vision

The desired future state. (Chs. 1, 8, 30)

Process of care

The desired sequence of steps that have been designed to achieve clinical standardization. (Ch. 1)

Cultural diversity

The differences that exist between multiple viewpoints based on ethnicity, gender, religion, socioeconomic status, and other variables. (Ch. 9)

Change outcome

The end product of a change process. (Ch. 17)

Change situations

The field comprising various factors and dynamics within which change is occurring. (Ch. 17)

Chain of command

The hierarchy depicted in vertical dimensions of organizational charts. (Ch. 8)

Respect for others

The highest ethical principle, respect for others acknowledges the right of individuals to make decisions and to live by those decisions. (Ch. 5)

Motivation

The instigation of action based on various factors, both intrinsic and extrinsic. (Ch. 1)

Nursing care delivery model

The method used to provide care to patients. (Ch. 13)

Span of control

The number of individuals a supervisor manages. For budgetary reasons, span of control is often a major focus for organizational restructuring. (Ch. 8)

Magnet Recognition program®

The only national designation built on and evolving through research. This program is designed to acknowledge nursing excellence. (Ch. 2)

Change management

The overall processes and strategies used to moderate and manage the preparation for, effect of, responses to, and outcomes of any condition or circumstance that is new or different from what existed previously. (Ch. 17)

Manager

The person with accountability for a group of people

Agency for Healthcare Research and Quality (AHRQ)

The primary federal agency devoted to improving quality, safety, efficiency, and effectiveness of health care. (Ch. 2)

Cultural competence

The process of integrating values, beliefs, and attitudes different from one's own perspective in order to render effective nursing care. (Chs. 9, 22)

Staff mix

The proportion of RNs to LPNs/LVNs to UAPs in a specific setting. (Ch. 13)

Expected outcomes

The result of patient goals that are achieved through a combination of medical and nursing interventions with patient participation. (Ch. 13)

Outcome criteria

The result of patient goals that are expected to be achieved through a combination of nursing and medical interventions. (Ch. 13)

Privacy

The right to protection against unreasonable and unwarranted interference with one's solitude; the right of an individual to be left alone. (Ch. 5)

Change process

The series of ongoing efforts applied to managing a change. (Ch. 17)

Emerging workforce

The so-called 20-something generation, who were born between the years of 1965 and 1985. (Ch. 3)

Organizational theory

The systematic analysis of how organizations and their component parts act and interact. (Ch. 8)

Management theory

The theory related to the activities described in Management. (Ch. 1)

Social networking

The use of technology and other mechanisms to create a web of relationships with common involvement in an area of focus or concern. (Ch. 1)

Chaos theory

Theoretical construct defining the random-appearing yet deterministic characteristics of complex organizations (see Nonlinear change). (Ch. 17)

Followership

Those with whom a leader interacts; involves assertive use of personal behaviors in contributing toward organizational outcomes while still acquiescing certain tasks to the leader or other team members. (Chs. 1, 19)

Leadership

Use of personal traits to constructively and ethically influence patients, families, and staff through a process in which clinical and org. outcomes are achieved through collective efforts. (Chs. 1, 3)

Problem solving

Using a systematic process to solve a problem. (Ch. 6)

Philosophy

Values and beliefs regarding nature of work derived from a mission and the rights/responsibilities of people involved. (Ch. 8)

Ethnocentrism

Viewing the world based on one's own reference group. (Ch. 9)