Management Test 2
What did the Wagner Act prohibit?
-Interfere with, restrain or coerce employees in a way that interfered with their rights -Interfere with the formation of any labor organization or to give financial assistance to a labor organization -Discriminate in hiring, tenure to discourage union membership -To discharge or discriminate against an employee who filed charges -Refuse to bargain in good faith
What type of expense does a nurse manager cut if she is struggling to meet the budget expectations?
-Labor expense (overtime and agency labor are the most costly) -Look at incremental overtime (personnel expenses).
what are limitations to decentralized staffing?
-Can result in more special pleading and arbitrary treatment of employees -May not be cost-effective for organization because staffing needs are not viewed holistically -More time consuming for manager
What is Part A Medicare?
(hospital, hospice, home health, skilled nursing) - federally funded, SS taxes
What is Part B Medicare?
(providers, outpatient, medical equipment, diagnostics) - funded 75% government, 25% individual; optional
What does indoctrination seek to do?
-Establish favorable employee attitude toward organization/unit -Provide information and education for success in position -Instill a feeling of belonging and acceptance
What is personal or referent power?
-Identify with a leader or what they represent, ability to attract others and build loyalty -Gives people a feeling of personal acceptance or approval -Can be based on personal charisma - referent power is gained only through association with powerful others, whereas charisma is a more personal type of power.
What is the induction phase of indoctrination?
Activities that educate new employee about the organization, employment, and personnel policies and procedures
NC has national standards of care and EBP treatment processes for common conditions on national priorities such as:
Acute Myocardial Infarction, Children's Asthma Care, Emergency Department, Hospital Outpatient Department, Hospital-Based Inpatient Psychiatric Services, Immunization, Perinatal Care, Stroke, Substance Use, Tobacco Treatment, Venous Thromboembolism
_________ has more flexibility than a line structure
Ad Hoc
___________ is Generally a modification of the bureaucratic structure that is temporarily in place until a project is completed.
Ad Hoc Design
_______ protects against forced retirement
Age discrimination and employment act
_____ act Workplace and social settings - rights in workplace are protected
American with disabilities act
A nurse manager contributes what skill in the budget development process?
Analyzing projected trends, contributing justification for capital needs, predicting labor expenses to name a few.
What is the adult method of learning?
Andragogy
What is a flat design?
Attempt to decentralize organization by removing hierarchical layers. Managers have greater control/responsibility
_________ Gap between position of authority and subordinate response
Authority-power gap
______ average number of patients per day in a hospital over a given period of time
Average daily census
What is the basis of your budget?
Average daily census+ average length of stay
________50-60s, workaholics, willing to work long hours, 40% of nursing workforce, still have children at home and take care of parents (Sandwich generation), like to challenge rules
Baby boomer or boom (1943 to early 1960s
____________ A tool used in strategic planning to develop metrics (performance measurement indicators), collect data, and analyze that data from four organizational perspectives: financial, customers, internal business processes (or simply processes), and learning and growth.
Balanced Scorecard
___________ Process of measuring products, outcomes, practices, and services against best-performing organizations
Benchmarking
_______Goals set to determine at what level the outcome indicators should be met
Benchmarks
_________ is a financial plan that includes estimated expenses as well as income for a period of time
Budget
_________ nurse hours per patient day, a benchmark, varies on the unit (hours in care over the average for that patient)
Budgeted Productivity
Part of Senge's theory where staff share the common vision and put personal goals and needs aside with focusing on teamwork?
Building Shared Vision
______________ is a system for controlling or managing an organization. Operated by officials employed to follow the rules carefully.
Bureaucracy
____________ plan for the purchase of buildings and major equipment, which include equipment over a set amount of money that has a long life (5 years <)
Capital budget
________ collaborative process that assesses, plans, implements, evaluates care services over the continuum
Case Management
_____________Type of patients served by an institution. A hospital's case mix is usually defined in such patient-related variables as acuity levels, diagnosis, personal characteristics, and patterns of treatment
Case Mix/CM Index
_____________ created to align payment and quality incentives and to reduce costs through improved quality and efficiency
Centers for Medicare and Medicaid Services (CMS)Pay for Performance
______ is where the individuals position falls within the organizational chart
Centrality
_______ is personal type of power (charm, persuasion)
Charismatic Power
_______ promotes employment based on ability and merit, prohibits discrimination based on race, religion, sex, and national origin
Civil Rights Act of 1964- Equal Employment opportunity Law
______ set standards for specific aspects of nursing practice
Clinical practice guidelines
___________Occurs between organized labor and management dealing with employee relations-- negotiating formal contracts
Collective Bargaining
_____ aid in management functions of an organization
Committees
During ______ discipline, Employee is reassured that punishment is given because of their actions and not because of who he or she is as a person
Constructive
_________patients' insurance companies make payments to doctors and hospitals based on the costs of the care provided to the patients.
Cost Based Reimbursement
________ systematic approach to estimating the strengths and weaknesses of alternatives--It is used to determine options that provide the best approach to achieve benefits while preserving savings.
Cost Benefit Analysis
_________Smallest functional unit for which cost control and accountability can be assigned.
Cost Center
______ means producing good results for the amount of money spent
Cost Effective
________ assessing, implementing, and evaluating the cost-effectiveness of patient care; used to improve care --These pathways reflect relatively standardized predictions of patients' progress for a specific diagnosis or procedure.
Critical pathways
_______ have helped to contain rising health- care costs
DRG's
_________ is a patient classification system that standardizes prospective payment to hospitals and encourages cost containment initiatives
Diagnosis related groups
________used by Medicare to determine payment rates for an inpatient hospital stay based on admission diagnosis.
Diagnostic Related Groups
________Involves training or molding the mind or character to bring about desired behaviors
Discipline
_________ in the organizational chart is staff/advisory position and has limited authority
Dotted/Broken Lines
_________more formal and broader in scope, designed to develop individuals in a broader sense
Education
__________Eliminate discrimination for: age, disability, national origin, pregnancy, race, religion, sex, sexual harassment, disability, retaliation, equal pay, and genetic information
Equal employment opportunity laws
___________Men and women should be receive equal pay, but both individuals must meet the same 4 tests in order to be paid the same.
Equal pay act of 1963
What are the four tests to be paid the same?
Equal skill, equal effort, equal responsibility, and similar working conditions
_____________ demonstrates that as RN hours decrease in NCHPPD, adverse patient outcomes increase, including increased medication errors and patient falls and decreased patient satisfaction with pain management.
Evidence in review or literature (ROL)
________Lifted restrictions and allowed public employees to organize-- allows for collective bargaining for nurses in public sector
Executive Order 10988
What did the Wagner Act Amended do?
Extended labor laws to private, non-profit hospitals, nursing homes, health clinics, Health Maintenance Organizations (HMO's) and other health care institutions.
__________laws in place to ensure we receive minimum wage, paid for overtime, and determines exemptions
Fair Labor Standards Act
Primary nursing is the most common care delivery model in the US. True/False
False - team nursing is the most common
______ cost-based retrospective reimbursement (pay for service or good you have received)
Fee for Service
______ Costs that do not vary according to volume.
Fixed Costs ex: mortgage and loan payments
_____ adjust over time to volume, labor costs, and capital expenses
Flexible Budgets
_____ use of historical data to make an educated budget estimate
Forecasting
What are Mcgregor's hot stove rule to make discipline as fair and growth producing as possible?
Forewarning, Immediate consequences, consistency and impartiality
______ structure provides a framework for defining managerial authority, responsibility, and accountability. Roles and functions are defined
Formal structure
_______Number of hours of work for which a full-time employee is scheduled for a weekly period.
Full time equivalent
_________tasks divided among care givers for a group of patients (this person does medication, this one does treatments, and this one does procedures)
Functional Nursing
_________30-40s, allow flexibility and time off, 40%, less economically driven
Generation X (Early 1960s to early 1980s)
________20-30, 15% of nursing workforce, work well as teams, very optimistic, digital natives (grown up with technology)
Generation Y (Early 80s to 2000)
__________teenagers volunteering in hospital
Generation Z
_____ is a broad measure of US economic health
Gross domestic product
_________ consider the status quo as the stable environment, energy is spent preventing change and maintaining conformity
Inactivism
_________ the budget is increased by a certain percentage no matter what if the budget is spent fully
Incremental Budgeting
_______ power is obtained when people have information that others must have to accomplish their goals.
Informational
What is a core measure compliance?
JC measures compliance with each recommended treatment for certain medical conditions
________ mission is to continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value.
Joint commission
_________regulations dealing with conditions of employee's work, physical conditions, financial aspects (minimum wage) and amount of hours worked (overtime)
Labor Standards
decentralized structure for decision making works better in ___________ because people with expertise needed are making decisions
Larger organizations
What are the different types of organizational charts?
Line Structure, Ad Hoc Design, Matrix Structure, Service Line, Flat Design
________ structure is a bureaucratic design found in large healthcare facilities
Line structure (Bureaucratic Design)
Bureaucratic organizational structures are also called _________
Line structures.
____ provides health coverage to uninsured children up to age 19
Louisiana LA Chip
In 1990, ___________ was established to identify organizations that attract and retain professional nurses
Magnet Hospital Recognition Program for Excellence in Nursing Services
__________ says that the hospital has excellence in nursing care, great patient outcomes, a lot of EBP, nursing peer review (review cases in the past to see what could have done different to get a better outcome)
Magnet hospitals
_______ term used to describe a variety of health care plans designed to contain he cost of health care services delivered to members while maintaining the quality of care
Managed care
What are the advantages of an organizational chart?
Maps lines of authority. Helps people understand their assignments and their coworkers. Contributes to sound organizational structure. Shows formal lines of communication
What is the orientation phase of indoctrination?
May include general orientation, tour of facility, training on fire safety, injury prevention, etc.
___________ Federally assisted and state-administered program to pay for medical services on behalf of certain groups of low-income individuals. Generally, these individuals are not covered by Social Security.
Medicaid
_________ Nationwide health insurance program authorized under Title 18 of the Social Security Act that provides benefits to people aged 65 years or older.
Medicare
________coverage also is available to certain groups of people with catastrophic or chronic illness, such as patients with renal failure requiring hemodialysis, regardless of age.
Medicare
_____ are the most common type of medical error
Medication errors
________ is when you compare medications the patient is/should be taking with medications ordered
Medication reconciliation
Part of Senge's Model where organization fosters organizational development through diverse thinking?
Mental Models
What are the chemicals most commonly abused by nurses?
Meperidine (Demerol), Oxycodone (OxyContin), Acetaminophen/Hydrocodone (Vicodin), Diazepam (Valium), Alcohol
_____________ is a brief statement identifying the reason why an organization exists (brief, but not that brief!)
Mission statement
____________Monitors quality of care, and accreditation is voluntary.
National Committee for Quality Assurance
________A system of insurance benefits established by a federal government to cover all or almost all of the citizens of the country. These systems are entirely or partially funded with tax money.
National Health Plan
___________ Safeguards the individual's right to organize. This board was formed to implement the Wagner Act.
National Labor Relations Board
JC established the _________________ to augment core measures and promote specific improvements in patient safety
National Patient Safety Goals
__________ emphasized outcomes and results instead of activities or outputs
New Performance Budgeting
___________usually associated with paid time off, such as sick time, vacation, jury duty, family leave, etc
Nonproductive hours
____________Provides a place of employment that is free from recognized hazards that may cause physical harm.
Occupational safety and health act
______ budget reflects fixed & variable expenses that change with volume of service, such as the cost of electricity, repairs and maintenance, and supplies. (day to day expenses)
Operating
_______ are values, language traditions, and customs that are not open for discussion or change. Can include values, philosophy, expectations.
Organizational culture
___________legal entity that contracts with a carrier for the purpose of providing or arranging for the provision of health care services to those persons covered under a carrier's health benefits plan, but which is not a licensed health care facility or other health care provider.
Organized Delivery System
________ audits are what results occurred, if any, as result of specific nursing interventions
Outcome
__________Assures that all Americans have access to affordable health insurance by reducing the barriers to obtaining health coverage as well
Patient Protection and Affordable Care Act
________Incentives are paid to providers to achieve a targeted threshold of clinical performance, typically a process or outcome measure associated with a specified patient population
Pay for performance
____________ percentage of revenue coming from private insurance versus government insurance versus self-paying individuals
Payer mix
What is the child method of teaching?
Pedagogy
Part of Senge's Model where staff members have a commitment to improve own personal abilities?
Personal Mastery
________ are plans reduced to statements of expectations that set boundaries for actions and decision making.
Policies
_____ requires clear decision making, assertiveness, accountability, and the willingness to express one's own views
Politics
______ is the capacity to get others to do something one wants them to do that they would not ordinarily do
Power
______ an experienced nurse who provides knowledge and emotional support, as well as a clarification of role expectations, on a one-to-one basis.
Preceptor
_____ audits are how nursing care is provided (way we deliver care influences quality of care)
Process audits
_____________ Total amount of regular time, overtime, and temporary time. This also may be referred to as actual hours.
Productive hours
_________Medicare payment is made based on a predetermined, fixed amount
Prospective Payment System
________ payment amount for a particular service is derived based on the classification system of that service
Prospective Reimbursement
__________An undesirable event that follows unacceptable behavior, which may have negative consequences but can be a powerful motivator for change
Punishment
________ are Activities that evaluate, monitor, or regulate services rendered to the consumer. It is an ongoing process.
Quality control
______ output of goods and services produced by labor and property located in the US
Real GDP
_______profitability ratio that measures the amount of return, or profit, an investment generates relative to its cost.
Return on Investment
____________Source of income or the reward for providing a service to a patient
Revenue/ revenue cycle
____ someone who is unusually effective or inspiring in some social role, job, etc. and thus serves as a model for others
Role model
_________ is the process by which rules are internalized and become part of the person's personality
Self-discipline
_______ is similar to a matrix design
Service line organization
What are the disadvantages of organizational charts?
Shows only formal relationships. Does not indicate degree of authority. Show things as they should be not as they are. Confusion of authority with status.
__________70-80s, 5% of nursing workforce, great depression, no risks, tremendous respect for authority, silent because they support status quo
Silent generation or veteran generation (1925 to 1942)
The Tart Hartley Amendment prohibited unfair labor practices of unions such as:
-Requiring the self-employed to join unions -Forcing employers to cease doing business with another person -Forcing employer to bargain with one union when another has been certified as the bargaining agent -Forcing employers to assign work to members of union as opposed to other workers -Charging excessive or discriminatory initiation fees -Causing or attempting to cause employer to pay if unnecessary services
_______ is Based on the premise that most behavior is learned through direct experience and observation
Social Learning Theory
What is destructive discipline?
-Use of threats and fear to control behavior -Employee always alert to impending penalty or termination (on edge) -Arbitrarily administered and either unfair in the application of rules or in the resulting punishment
What are the advantages to a bureaucracy?
-clear lines of authority -fair/predictable decisions -clear rules, duties, and regulations
What are the disadvantages of a bureaucracy?
-predisposed to authoritarian leadership -use of rewards and punishment -faceless decision making -lack of flexibility
A nurse works 3- 12 hour shifts/week. How many FTEs does that nurse fill?
0.9 FTEs
_______ is an important phase of the management process in HC agencies because organizations are usually labor intensive
Staffing
_______ are Entities in the organization's environment that play a role in the organization's health and performance or are affected by the organization
Stakeholders
_________consistent terminology for nursing care, the lingo that nurses use to communicate to each other
Standardized nursing language
__________ audits are relationship exists between quality care and way the organization is structured (staffing, wait times, etc.)
Structure audits
_______requires the nurse to note the frequency of occurrence of specific activities, treatments, and procedures/patient.
Summative task patient classification system
Part of Senge's Model where staff members are encouraged to see themselves as connected to the whole organization?
Systems Thinking
What are the 5 concepts of Senge's Learning organization Model?
Systems thinking personal mastery team learning mental models building shared vision
Part of Senge's Model where collaboration to achieve goals occurs within the team?
Team Learning
______ is a group of patients cared for by a team of care givers
Team nursing
_________number of units that can be produced by a production process within a certain period of time-how quickly is the patient moved through the hospital
Throughput
_________ model is a basic assumption that quality can always be improved. Promotes problem prevention planning
Total Quality Management
__________ delivery in an organized way to ensure staff has knowledge/skills to perform the job
Training
____________ is responsible for ensuring adequate number of staff and appropriate mix of staff
Unit Manager
______ are the workload units
Unit of service
__________ Costs that vary with the volume. Payroll costs are an example.
Variable costs
______ is anything over the budget
Variance
_______ is the difference between the budgeted or baseline amount of expense or revenue, and the actual amount
Variance
_________ explains your variance; quantitative explanation for any variance that occurs
Variance analysis
_________Provides reemployment rights
Vietname Veterans act
_________Established workers' right to organize (allowed nurses the ability to collectively bargain)
Wagner Act (National Labor Relations Act)
______ means you should re-justify program or needs yearly
Zero Based Budgeting
__________ is when individuals agree to be morally responsible for consequences of their actions.
accountability
Required to have a quality improvement program in order to be ______
accredited
__________adverse changes in health that involves a medication (do not always occur from a medical error)
adverse drug events
what are some illegal interview inquiries?
age, marital status, children, race, sex, credit rating, national origin, and religion
Steps in the Budgetary Process:
asses what needs to be in the budget diagnoe what needs to be accomplished develop a fiscal plan implement the plan evaluate the plan make adjustments and explain variances
________ An official, systematic tool - are we meeting our benchmarks?
audits
_____ when someone has the official power to act. Given by the organization.
authority
what kind of structure does an organization have?
both formal and informal
___ rate at which dollars are received and dispersed
cash flow
______ is formal paths of communication and authority. Represented by solid lines on organizational chart.
chain of command
What changed in Joint commission in the 1990's?
changed the accreditation process from organizational structure to organizational performance (patient outcomes)
_________ process used by doctors and other health care providers so that they get paid for their services.
charge capture
________ is impairment resulting from drug or alcohol addiction
chemical impairment
_______ Occurs when the staff members on a unit make a commitment to cover all absences and needed extra staffing (i.e. to cover increased patient census) in return for not being pulled from the unit in times of low census.
closed unit staffing
both short term and longer term goals should be _______ with each other
congruent
What are the 3 type of discipline?
constructive, destructive, self-discipline
What is a service line organization?
coordinates all aspects of diagnosis/care around patient needs. Patients receive all needed services from an integrated team of providers at a single location (one stop shop)
_____ is how much patient pays out of pocket for the service, and _____ is how much money the good or service is asked for by the provider
cost, charge
_______________ uses broad indicators such as bathing, diet, intravenous fluids and medications, and positioning to categorize patient care activities.
critical patient classification system
The balanced scoreboard objectives measures align individual, departmental, and organizational goals and identify entirely new processes for meeting _________
customer and shareholder objectives
Who makes decisions in a decentralized structure?
decisions made/problems solved at the level in which they occur
When is functional nursing best used?
during a crisis/disaster
______ Can be defined as decentralization of power, sharing power-- to develop, enable and allows to reach potential
empowerment
What is the aim of shared governance?
empowerment of employees within the decision making system
What is the product in a matrix structure?
end results ( patient outcomes)
What is an efficient size for a committee?
enough members to accomplish the tasks but not too many to obscure discussion (6-8)
What are the standards of professional performance?
ethics, education, EBP, quality of practice, communication, leadership, collaboration, professional practice evaluation, resource utilization.
Who is responsible for cost containment?
every healthcare provider
What did the Taft Hartley amendment do?
excluded nonprofit hospital workers
What does a bureaucracy lead to?
fair and predictable managerial actions
An essential feature of fiscal planning is responsibility accounting, which means that each of an organization's revenues, expenses, assets, and liabilities is someone's responsibility which is_________
fiscal responsibility
_____financial pressures and electronic communication have increased the span of control resulting in "flattening of the organization."
flattening of the organization
___________ involves trying to estimate how a condition will be in the future.
forecasting
What kind of chain of command does a matrix structure have?
formal vertical and horizontal where an individual reports to more than one person (grid like)
_________ may be defined as the desired result toward which effort is directed; it is the aim of the philosophy.
goal
What kind of communication does informal structure have?
grapevine-- social with blurred lines of authority
A _____ is essentially a statement of wrongdoing
grievance
______________ degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.
healthcare quality
Intrarater reliability is __________ with multiple interviews
high
What are assets to adult learning?
high self-motivation, self-directed, a proven learner, knowledge and experience, special individual assets
What are some examples of internal stakeholders?
hospital employees, physicians, patients, families, union shop stewards, board of directors
What is the purpose of the national patient safety goals?
improve patient safety and assist in addressing patient safety concerns
_______ is the planned, guided adjustment of an employee to the organization and work environment
indoctrination
what are the 3 phases of indoctrination?
induction, orientation, and socialization
______ structure forms naturally among employees
informal
What are obstacles to adult learning?
institutional barriers, time, self-confidence, situational obstacles, family reaction, special individual obstacles
What is the goal of planning?
interactive/proactive
____________ Considers the past, present, and future; specific activities are done to achieve desired state
interactive/proactive planning
What are the limitations to an organizational chart?
it defines authority but does not define responsibility and accountability
________ is when tolerance is developed to the chemical and the individual needs the chemical in greater amounts and more often to achieve the same effect
late stage chemical dependency
What are some example of external stakeholders?
local businesses, area colleges and universities, insurance companies and HMO's, unions, professional organizations
Interrater reliability is ______ in unstructured interviews
low
_________ is when you are Forced to work additional shifts, often under threat of patient abandonment. Hurts the employees' morale.
mandatory overtime
_________These employees disrupt unit functioning because the quantity or quality of their work consistently meets only minimal standards
marginal employees
______ structure are focused on product and function
matrix structure
_____________a distinctive interactive relationship between two individuals, occurring most commonly in a professional setting.
mentor
who promotes retention and impacts positive culture on the unit?
middle manager
______ have the broadest view of the organization and the most centrality. They receive downward, upward, and horizontally communication
middle managers
_______ is a condition for participation in Medicare and is required by the Joint Commission for certification.
national level patient care system
Should the manager assume the role of a counselor for a chemically dependent nurse?
no
Are top level managers usually involved in day to day operations?
not usually
What is NCH/PPD and what does it measure?
nursing care hours (worked in 24 hrs)/ per patient day inpatient unites
who deals with issues related to nursing practice in a shared governance?
nursing councils
What are the objective requirements?
oA specific time frame in which the objectives are to be completed oShould be stated in behavioral terms "so and so will do such and such" oBe objectively evaluated oIdentify positive outcomes rather than negative outcomes.
What is punishment or coercive power?
oBased on fear and punishment if the manager's expectations are not met. oThe manager gets compliance through threats - dismissal, layoff, or demotion. oManager berates or belittles the employee.
how do you bride authority power gap?
oFollowers believe that the manger is doing a good job oFollowers believe that the organization has their best interests in mind oFollowers do not feel controlled by authority oManagers get to know the employees
What is legitimate power?
oGained by the title or position oCreates a feeling of obligation and responsibility
What is expert or knowledge power?
oGained through knowledge, expertise, and experience. oThis type of power is limited to a specialized area.
What is reward power?
oGrant favors or rewards as desired by employees oInfluences employees to work toward meeting goals oPositive leadership through rewards tends to develop a great deal of loyalty and devotion toward leaders.
what is the strength of decentralized staffing?
oManager retains greater control over unit staffing oStaff are able to takes requests directly to their manager oProvides great autonomy and flexibility for individual staff member
What are the limitations to centralized staffing?
oProvides less flexibility for the worker and may not account for a specific worker's desires or special needs oManager may be less responsive to personnel budget control in scheduling and staffing matters
what are the strengths of centralized staffing?
oProvides organization-wide view of staffing needs, which encourages optimal utilization of staff resources oStaffing policies tend to be employed more consistently and impartially oMore cost-effective than decentralized staffing oFrees the middle-level manager to complete other management functions
What is a structured interview?
oRequires greater planning time oQuestions are developed in advance oDiscuss skills and qualities that are looked for oDiscuss applicant's experience - interviewer talks 50% of the time oAll applicants are asked same questions
What is an unstructured interview?
oRequires little planning oGoals are not clear oQuestions are not prepared in advance oInterviewer does most of the talking
What is a semi-structured interview?
oRequires some planning oFlow is focused and directed at major topic areas oThere is flexibility in the approach
_______are similar to goals in that they motivate people to a specific end and are explicit, measurable, observable or retrievable, and obtainable.
objectives
_______ refers to how employees perceive an organization
organizational climate
The _________ flows from the purpose or mission statement and delineates the set of values and beliefs that guide all actions of the organization.
organizational philosophy
Joint commission standards are developed with input from?
other healthcare professionals
_____________ budget is the largest budget expenditure because the healthcare is labor intensive
personnel
________ is the art of using legitimate power wisely and effectively
politics
_________ utilizes technology to accelerate change and are future oriented
pre activism
_____ provides total direct care for the patient
primary nurse or relationship-based nurse
________are plans that establish customary or acceptable ways of accomplishing a specific task and delineate a sequence of steps of required action.
procedures
____ what is left over after paying expenses
profit/bottom line
_____ anyone that provides a good or service
provider
______is typically exemplified in female dominated professions-- once successful they do not assist others in their success-- leads to inadequate empowerment
queen bee syndrome
____ plan after a problem exists
reactive planning
_____ is Process of actively seeking out and attracting applicants for positions
recruitment
_________ Protects the disabled in federal employment
rehabilitation act
The higher the CM the higher _____ needed for that patient population
reimbursement
What are some examples of national patient safety goals?
responding to alarms, preventing infection
_____ is referring to duty or assignment because of their position; implementation of a job
responsibility
________ occurs only when the organization is able to create a work environment that makes staff want to stay
retention
What is the most common reason for discipline?
rule breaking
________are plans that define specific action or nonaction.
rules and regulations
Joint commission standards are informed by ____ and reviewed by _______
scientific literature Board of commisioners
What is the highest and most effective form of discipline?
self- discipline
JC maintains one of the nations most comprehensive database of ______ events by health-care professionals and their underlying causes
sentinel
________ is when position or area really hard that is really hard to work, set a price for the shift, set shift at a higher rate
shift bidding
In effective planning, the manager must identify_________________ and changes needed to ensure that the unit will continue to meet its goals.
short- and long-term goals
What are the critics of the prospective payment system?
shorter hospital stays and serviced provided have resulted in reduced quality of care
_______ in the organizational chart is the official chain of command and top has highest level decision-making
solid vertical lines
________the number of people directly reporting to any one manager (3-50 people).
span of control
______ is a predetermined level of excellence that serves as a guide for practice.
standard
_______ Forecasts the future success of the organization by matching and aligning it's capabilities with its external opportunities
strategic planning
_________Focuses on the purpose, mission, philosophy and goals in relation to the external environment
strategic planning
SWOT analysis measures what 4 things in planning?
strengths, weaknesses, opportunities, and threats
Interrater reliability is better if interview is ________
structured
_________ involves maladaptive patterns of psychoactive substance abuse, with the substance user continuing use in face of recurrent occupational, social, psychological or physical problems, and/or dangerous situations
substance misuse
What is the function in a matrix structure?
tasks required to produce the product (staff development, RN to patient ratio)
Validity increases when there is a ___________ to the interview
team approach
who does the fiscal responsibility usually fall to?
the manager
healthcare involves a _______ reimbursement
third party
Who makes the decisions in a centralized structure?
top managers
On a hierarchy, the plans at the ______ influence the plans at the_______
top, that fall below
as a bedside nurse how can we promote cost containment?
use supplies and staffing wisely
_________ the action of making practical and effective use of something.
utilization
What are the four common steps in progressive discipline?
verbal admonishment, written admonishment, suspension from work without pay, dismissal
________ describe the future goals and aims of an organization
vision statement
What is decentralized staffing?
when each unit making staffing decisions
What is centralized staffing?
when one place is doing staffing
What happens to the authority-power gap when a manager asks personal questions of their employees?
widens it
What does the Patient Protection and Affordable Care Act do?
•Allows young adults to be covered by parents up to 26 •Prohibits cancellation for pre-existing conditions •Funds preventative care and some nurse practitioner visits •Forces employer health insurance coverage of full time employees •Tax credits for businesses •Insurance coverage may be taxable income for the recipient
What are the Joint Commission Standards?
•Assist health care organizations to measure, assess and improve performance •Focus on important patient, organization functions that are essential to providing safe, high quality care
What is the Revenue Cycle Process?
•Starts at scheduling, preregistration •Point of service registration, collections •Encounter utilization review/Case management •Charge capture and coding •Claim submission •Third Party follow up •Remittance processing and rejections •Payment posting, appeals, collections
What do top level managers do?
(CEO) -look at the organization as a whole -oversee more than nursing -set goals for resources, set policy
What do first level managers do?
(charge nurse) -unit day to day needs/problems -relies on middle manager to communicate with top level managers
What do middle level managers do?
(directors, managers) -day to day unit needs -long term and short term planning
What is Medicare Part D?
(drug benefit plans) - went into effect in 2006; limited prescription drug coverage
What is the process of quality control?
1. Standars are determined 2. information is collected to see if standard has been met 3. educational action is taken if standard hasn't been met
Steps to Audit Quality control:
1. establish control criteria 2. identify information relevant to criteria 3. determine ways to collect information 4. collect and analyze information 5. compare collected information with criteria 6. make judgement about quality 7. provide information and take corrective action 8. Reevaluate
What is the disciplinary conference?
1.State the problem clearly 2. Ask the employee why there has been no improvement 3.Explain the disciplinary action to be taken 4.Describe the expected behavioral change 5.Get agreement to and acceptance of the plan
_____ hours worked a year is 1 FTE
2,080
how long is a rehab plan for chemically dependent nurses?
2-5 years
The NLB demonstrates • an adequate level of desire for unionization among employees need at least ________ before a vote can be taken.
30%
How many hours does 1.0 FTE work per week?
40 hours per week
annual health care expenditures is expected to reach ________ by 2026
5.7 trillion
______ is the average nurse age
50 years
_________ to _____ is paid by the federal government for medicaid
50% to 83%
Only about ________% of hospitals have magnet status
7
Want atlases an _______% utilization rate for a unit
80%
What is the professional organizations standard of practice in nursing?
ANA Scope and Standards for Nursing Practice
_________ pays health plans or providers a fixed amount per enrollee per month for a defined set of health services, regardless of how many (if any) services are used.
Capitation
_______difference between what hospitals bill and what they receive in payment from third party payers, most commonly government programs
Contractual allowance
T/F Empowering subordinates undermines one's power.
False
_______ need to capture all charges
nurses
The higher the case mix, the _____ the patients
sicker
How do you measure home health?
visits per month