NUR-514 Discuss How the Shift to Value-based Health Care has Impacted Delivery of Care and the Role and Responsibilities of the Advanced Registered Nurse
NUR 514 Topic 1: Health Care Systems, Organizational Relationships, And Interprofessional Health Care Environments
Max Points:30 Objectives:- Discuss the evolution of the U.S. health care system its impact on nursing and the delivery of care.
- Explain how interprofessional relationships increase collaboration and improve patient outcomes.
- Examine how leaders benefit from applying systems thinking.
Leadership in Nursing Practice: Changing the Landscape of Health Care Read Chapter 9 in Leadership in Nursing Practice: Changing the Landscape of Health Care. View Resource
Interprofessional Collaboration: Three Best Practice Models of Interprofessional Education Read “Interprofessional Collaboration: Three Best Practice Models of Interprofessional Education,” by Bridges, Davidson, Odegard, … Read More https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3081249/
Core Competencies for Interprofessional Collaborative Practice: 2016 Update Read “Core Competencies for Interprofessional Collaborative Practice: 2016 Update,” by the Interprofessional Education Collaborat … Read More https://ipec.memberclicks.net/assets/2016-Update.pdf
Using Systems Thinking to Envision Quality and Safety in Healthcare Read “Using Systems Thinking to Envision Quality and Safety in Healthcare,” by Stalter and Mota, from Nursing Management … Read More https://journals.lww.com/nursingmanagement/fulltext/2018/02000/using_systems_thinking_to_envision_quality_and.7.aspx
AONL Nurse Leader Competencies Read “AONL Nurse Leader Competencies,” located on the American Organization for Nursing Leadership (AONL) website. https://www.aonl.org/resourc
Topic 1 DQ 1
Consider the evolution of the U.S. health care system. Discuss how the shift to value-based health care has impacted delivery of care and the role and responsibilities of the advanced registered nurse. Project what major evolving trends in the health care delivery system will affect nursing practice and how advanced registered nurses will influence the direction of health care.Topic 1 DQ 1 Example Solution Rosette
The healthcare system in the U.S. keeps evolving and yet still fragmented, and compared to other countries, the U.S. has higher healthcare spending. According to HEOR (n.d.), the U.S. healthcare system can be defined as a mixed system, as there is no universal coverage. There is government funding, which includes Medicare and Medicaid, and privately financed or from private health insurance plans and out-of-pocket payments. In 2010, the Affordable Care Act (ACA) or “Obamacare,” or the comprehensive health care reform law, was enacted. Davalon (2022) stated that the ACA significantly changed the U.S. healthcare system by reducing the amount individuals and families paid for uncompensated care. The U.S. healthcare system began to experience a shift in how healthcare services are delivered and paid for after the ACA (Veradigm, n.d.). Many health care reforms have been implemented to emphasize quality of care over quantity (Veradigm, n.d.). According to Veradigm (n.d.), “Value-based healthcare is a healthcare delivery framework that incentivizes healthcare providers to focus on the quality of services rendered, as opposed to the quantity.” As The University of Michigan (2021) stated, the three main goals of Value-Based Care are often referred to as the triple aim: better care for individuals, improved public health, and lower costs. In addition, BVC acknowledges that “higher health care costs do not lead to better outcomes” and that provider workflow designed to maximize throughput can lower the quality of Care (U.M., 2021). BVC also promotes the kind of collaborative partnerships among providers, administrators, and patients that drive down costs while improving standards of Care (U.M., 2021). Comunale et al. (2021) stated that with the radical change in the healthcare system, hospital organizations had to evaluate new models of care that will support high-quality but low-cost care while maintaining timely patient access and reduced wait times. They stated that collaboration between physicians and Advanced Practice Providers (APPs) would be the key mechanism to providing care in the new care model. Nurse leaders have several roles to play in VBC; they can help expand the scope of advanced practice registered nurses’ practice across the U.S., reducing costs and expanding access to care (U.M., 2021). Word Count: 356 References: Comunale et al. (2021). Integrating Advanced Practice Providers into value-based care strategies: One organization’s journey to achieve success through interprofessional collaboration https://www.acponline.org/system/files/documents/practice-resources/patient-interprofessional-education/teambased-care-toolkit/integratng_advanced_practice_providers_-jiep.pdf Davalon (2022). History and Timeline of the Affordable Care Act (ACA) https://www.ehealthinsurance.com/resources/affordable-care-act/history-timeline-affordable-care-actaca#:~:text=The%20ACA%20significantly%20changed%20the,who%20cannot%20afford%20a%20plan. Heor, (n.d.). U.S. Healthcare System Overview-Background https://www.ispor.org/heor-resources/more-heor-resources/us-healthcare-system-overview/us-healthcare-system-overview-background-page-1 Veradigm, (n.d.). What is Value-based healthcare? A comprehensive guide. https://veradigm.com/what-is-value-based-healthcare/#:~:text=Value%2Dbased%20healthcare%20is%20a,based%20upon%20patient%20health%20outcomes. The University of Michigan, (2021). Value-Based Nursing Care Strategies & Readiness Checklist https://online.nursing.umich.edu/blog/value-based-nursing-care-strategies-and-readiness-checklist/Topic 1 DQ 1 Example Solution 2 Devera
Value-based health care was developed in response to the rising health care costs, poor quality outcomes, and shifting demographics; It is the underlying strategy in Healthcare Reform, also known as the Affordable Care Act (ACA) of 2010 which aimed at enhanced patient experience and outcomes, improved population health, and reduced health care expenditures (Huffman, 2020). Since the shift from payment for volume of services provided to payment for quality outcomes, health care organizations have put a lot of focus on quality metrics and patient experience for reimbursements. Patients demand quality and satisfaction at a low cost. The goal is for providers and nurses to keep people healthy for insurance companies to pay out less for services and that would reduce premiums for the consumer. The role of the advanced registered nurse has grown tremendously due to value-based health care. As leaders in health care nurses and APRNs are at the forefront of value base care as they carry the most influence on coordination of patient care outcomes and satisfaction. Key strategies to facilitate this enhanced coordination of care include a focus on patient and family engagement, self-management skills, interdisciplinary collaboration, and effective communication and these nursing interventions are the first step on the journey to reduce readmissions, improve patient outcomes, and reduce cost (Huffman, 2020). Value based health care has put a lot of emphasis on comprehensive patient education and prevention which is a vital role that advanced registered nurse play to teach self-care and avoid complications and costly hospital admissions. APRNs use their advanced knowledge and leadership skills to champion quality improvement and patient experience projects, they may increase financial reimbursement within the value-based system, thus demonstrating value to the health care institution (Constable et al., 2022). APRNs as leaders in health care create and influence policy that impacts quality outcomes, safety and patient experience. Value based health care will continue to provide opportunities for APRNS to use their expertise to improve clinical outcomes, health care safety, and patient experience while also demonstrating their value to health care systems (Constable et al., 2022) Telemedicine is also growing as patients need access to everyone from general practitioners to specialists, regardless of their location and these services fit the needs of younger generations who may not have a primary care provider (PCP) and require on-demand services (Orand, 2019). Health care technology is continually advancing adding more tools for providers to help manage patients outside of hospitals and clinics and keep patients engaged in their health care and fostering selfcare and maintain a healthier lifestyle. Virtual visits and digital tools that enable remote patient monitoring can engage patients more consistently and deeply in their own care which is a critical component of any value-based care program (Ruby, 2021). Value based health care and telemedicine has shifted more focus to outpatient preventative care. With telemedicine allowing for more and easier access to practitioners will continue to increase the demand for more APRNs. Word Count: 489References:
Constable, M., Mulkey, M. & Aucoin, J. (2022). Hospital value–based purchasing: How acute care advanced practice nurses demonstrate value. Journal of the American Association of Nurse Practitioners, 34(1), 12-17. https://doi: 10.1097/JXX.0000000000000606. Huffman, M. (2020). Value-Based Care: An Executive Briefing. Nurse leader, 19(1). 82-86. https://doi.org/10.1016/j.mnl.2020.07.014 Orand, J. (2019). The Shift to Value-Based Healthcare and How It Impacts Optimum Reimbursement. Symplr. Retrieved from https://www.symplr.com/blog/the-shift-to-value-based-healthcare-and-how-it-impacts-optimum-reimbursement Ruby, J. (2021). The shift to value-based care has accelerated in the wake of the pandemic. Med City News. Retrieved from https://medcitynews.com/2021/04/the-shift-to-value-based-care-has-accelerated-in-the-wake-of-the-pandemic/Topic 1 DQ 2
Based on your experience, explain how systems thinking helps leaders to build strong interprofessional and organizational relationships. Discuss some system thinking tools nursing leaders can apply to increase interprofessional collaboration to benefit patient outcomes or organizational initiatives. Make sure to incorporate the Interprofessional Education Collaborative (IPEC) competencies in your response.Topic 1 DQ 2 Example Solution Ashley L
In nursing, system thinking is a process of awareness about clinical boundaries, authority, hierarchy of the medical field, and the awareness of interdependencies- meaning nurses displaying strong leadership skills can implement change for the better of the unit/hospital. It is important for nurses implementing system thinking skills to understand the importance of interrelationships among nurses and other healthcare professionals (Statler& Mota, 2018). It is imperative that nurses, doctors, therapists, etc work together to improve the patient’s outcome and make treatments run smoothly. Nurse leaders and educators can use their experience and skills in system thinking to help others understand the steps they can take and roles they play in reaching a common goal within their organization (Statler & Mota, 2018). A nurse can inspire others to take action by being role models in promoting interprofessional teamwork, leading change, and creating an environment of mutual respect and team collaboration (Statler & Mota, 2018). IPEC was created to develop core competencies and to build upon each profession’s disciplinary competencies. The intention was to get students of different health professions engaged in other professions learning to better integrate population health approaches across different professions, leading to better collaborative work. Their goal is to teach a variety of healthcare disciplines to students to help aid in better interprofessional relationships (McKearney, n.d.). Because of IPEC, nurses and nurse leaders know their defined role in a patient’s care and can incorporate and interact with other professions to reach the common goal- a healthy patient outcome. By having strong interdisciplinary communication, patients can feel they are receiving proper care with a team that works together, rather than against each other, which I have witnessed many times. Doctors of other specialties will go against one of another specialty or talk negatively about the plan of care created by the other team. This does not give a patient faith in the care they will receive. Nurses and nurse leaders can help bridge this gap by accurately relaying information to each specialist care team involved. As a patient’s care team, each individual has their own specialized skill set, therefore working together leads to a higher functioning team. Another way nurse leaders can implement system thinking, is by encouraging others to create a fair, just environment. It is important that we take responsibility for our actions, own our mistakes, reporting near misses, reporting system breakdowns, such as communication issues, and lack of supplies essential for patient care (Statler & Mota, 2018). Nurse leaders and educators can use their skills to teach others how to create individualized care plans and get the patient involved in their care. This leads to more compliant patients with a better understanding of their health issues. WC 430 References$ Stalter, A. M., & Mota, A. (2018). Using systems thinking to envision quality and safety in healthcare. Nursing management, 49(2), 32-39. https://journals.lww.com/nursingmanagement/fulltext/2018/02000/using_systems_thinking_to_envision_quality_and.7.aspx McKearney, S. (n.d.). About Us. Interprofessional Education Collaborative. Retrieved August 8, 2022, from https://www.ipecollaborative.org/about-usReplies to Ashley L
Nurse leaders must be understanding of the complexity and importance of interprofessional and organizational relationships. The responsibilities a leader carries are widely varied and continue to increase in significant ways. It is imperative for Interprofessional Education Collaborative (IPEC) to be incorporated and implemented from the beginning of one’s nursing career. This includes the initiation of their function and values from the start as nursing students. With the incorporation of the IPEC, the goal is to improve health care and advance the growing health population with an effective framework of medical professionals. “Students trained using an IPE approach are more likely to become collaborative interprofessional team members who show respect and positive attitudes towards each other and work towards improving patient outcomes” (Bridges, Davidson, Odegard, Maki & Tomkowiak, 2011). The importance of teamwork as a leader is imperative to the success of the overall mission. Working as an intensive care nurse leader has shown me that we cannot function alone, and we must find cohesion with the support and collaboration of interprofessional teams. System thinking provides leaders with a deeper insight and utilization of up-to date practices that coincide with the infrastructure of the IPEC. “Systems thinking is a process of self-awareness in which the nurse knows boundaries specific to clinical reasoning, personal effort, reliance on authority, and awareness of interdependencies” (Stalter & Mota, 2018). A prime example is the increase incorporation of evidence-based practices with other professions to optimize care with the common goal of quality care. This coincides with one of the core competencies through values and ethics for interprofessional practice. Through collaboration of multidisciplinary teams, these practices are increasing the quality and safety of care throughout healthcare. This system coincides with the incorporation of a value-based health care system. In conclusion, implementing IPEC and integrating system think tools into our practice is a critical aspect of progressing forward in our professional development.References
Bridges, D. R., Davidson, R. A., Odegard, P. S., Maki, I. V., & Tomkowiak, J. (2011). Interprofessional collaboration: three best practice models of interprofessional education. Medical education online, 16, 10.3402/meo.v16i0.6035. https://doi.org/10.3402/meo.v16i0.6035 Stalter, A. M., & Mota, A. (2018). Using systems thinking to envision quality and safety in Healthcare. Nursing Management, 49(2), 32–39. https://doi.org/10.1097/01.numa.0000529925.66375.d0 Word Count: 314NUR 514 Topic 2: Professional Leadership
Objectives:- Differentiate between leadership and management.
- Analyze different leadership theories and styles.
- Analyze characteristics of the professional nurse leader and nursing leadership.
- Evaluate leadership and management strategies within health care organizations.
- Discuss potential causes of conflict, principles of negotiation, and conflict resolution models and strategies.
Leadership in Nursing Practice: Changing the Landscape of Health Care Read Chapters 2-4, 7, and 14 in Leadership in Nursing Practice: Changing the Landscape of Health Care. View Resource
Great Leaders Inspire Great Followership Read “Great Leaders Inspire Great Followership,” by Cruz, from Leadership Excellence (2014). https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=bth&AN=97399121&site=ehost-live&scope=site&custid=s8333196&groupid=main&profile=ehost
Advancing the Nursing Profession Begins With Leadership Read “Advancing the Nursing Profession Begins With Leadership,” by O’Neill, from Journal of Nursing Administration (2013 … Read More https://lopes.idm.oclc.org/login?url=http://gateway.ovid.com.lopes.idm.oclc.org/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=ovft&AN=00005110-201304000-00001&PDF=y
From Trait to Transformation: The Evolution of Leadership Theories Read “From Trait to Transformation: The Evolution of Leadership Theories,” by Johns and Moser, from Education (1989). … Read More https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=4717838&site=ehost-live&scope=site
Nursing Leadership From Bedside to Boardroom: Opinion Leaders’ Perceptions Read “Nursing Leadership From Bedside to Boardroom: Opinion Leaders’ Perceptions,” by Blizzard, Khoury, and McMurray (2015), loca
Leadership Styles: Choosing the Right Approach for the Situation Read “Leadership Styles: Choosing the Right Approach for the Situation,” located on the Mind Tools website. http://www.mindtools.com/pages/article/newLDR_84.htm
Transformational Leadership: Becoming an Inspirational Leader Read “Transformational Leadership: Becoming an Inspirational Leader,” located on the Mind Tools website. http://www.mindtools.com/pages/article/transformational-leadership.htm
Servant Leadership: Putting Your Team First, and Yourself Second Read “Servant Leadership: Putting Your Team First, and Yourself Second,” located on the Mind Tools website. https://www.mindtools.com/pages/article/servant-leadership.htm
What Is the Difference Between Management and Leadership? Read “What Is the Difference Between Management and Leadership?” by Murray (2014), located on The Wall Street Journa … Read More
An Alternative Approach to Nurse Manager Leadership Read “An Alternative Approach to Nurse Manager Leadership,” by Henriksen, from Nursing Management (2016). https://journals.lww.com/nursingmanagement/Fulltext/2016/01000/An_alternative_approach_to_nurse_manager.13.aspx
Nurse Manager Skills Inventory Complete the “Nurse Manager Skills Inventory,” by the Nurse Manager Leadership Partnership (NMLP), located on the HWE Resources p … Read More https://www.aacn.org/nursing-excellence/healthy-work-environments/hwe-resources
Leadership Style Reflective Essay Assignment Self-Assessment Resources These resources will be used to complete the Leadership Style Reflective Essay assignment, due in this topic. Please refer to the assignm … Read More
What Is Servant Leadership? Explore the “What Is Servant Leadership?” page of the Greenleaf Center for Servant Leadership website. https://www.greenleaf.org/wh
Topic 2 DQ 1
Differentiate between “leading” and “managing.” Based on your experience in the health care industry, explain how an advanced registered nurse can lead well and provide management. Share at least one strategy you have used to effectively lead and manage staff within health care organizations Consider interactions with patients, team members, daily tasks, and responsibilities as you formulate your response.Topic 2 DQ 1 Example Solution
I have always seen managers and leaders as two separate roles. The title of manager comes with the job and authority they were given. A leader is a title that is earned with credibility and vision. Management focuses on efficiency, function and processes while leadership focuses on relationship, interactions and influence (Weberg et al., 2019). Not all managers are good leaders, and anyone can be a good leader. Managing is performing the defined technical skills and duties needed for maintaining a department of staff. Leading is inspiring, motivating or encouraging the team or individuals that do the work. Advanced practice registered nurse can both lead and provide management. Advanced practice nursing leadership and its contribution to improving the care environment for patients and families, nurses and other healthcare providers, organizations and the healthcare system (Lamb et al., 2018). APRNs have the education, expertise and skills to manage and lead nurses and their peers within their organizations. They know the business of health care and its challenges to meet the expectations of the organizations they belong to. APRNs have the technical knowledge and research skills to develop policy and strategies towards organizational goals and quality outcomes. As leaders, APRNs can have the ability to influence nurses and patients towards shared goals. APRNs must have good and direct communication skills to inspired and challenge others to meet desire outcomes. As a nurse manager one strategy I use to manage and lead my team is open, honest and effective communication. I accomplish this with rounding daily with my team and patients. I first start my day with a morning huddle meeting with staff and reviewing our organizational and department goals and opportunities. I elicit feedback and advice from them on what are the barriers and issues that may prevent them from delivering good care and understand their concerns. And throughout the day I try to meet with each one individually starting off casually then some to a more simi-formal meeting. I tend to incorporate servant leadership with active listening, stewardship and growth. It is important to maintain trust and understanding between my staff and myself. When I round with patients I focus on active listening, providing empathy and making sure their individual needs are met. Word Count: 372References:
Lamb, A., Martin-Misener, R., Bryant-Lukosius, D., & Latimer, M. (2018). Describing the leadership capabilities of advanced practice nurses using a qualitative descriptive study. Nursing open, 5(3), 400–413. https://doi.org/10.1002/nop2.150 Weberg, D., Mangold, K., Porter-O’Grady, T., & Malloch, K. (2019). Leadership in nursing practice: Changing the landscape of health care (3rd ed.). Jones & Bartlett Learning. ISBN-13: 9781284146530Topic 2 DQ 2
Discuss potential causes of conflict occurring within health care organizations. What are some principles of negotiation and conflict resolution used by the nurse leader to address conflict? What model or leadership theory would be effective to use in addressing conflict?Topic 2 DQ 2 Example Solution
There are many potential causes of conflict within a health care organizations. The biggest one that stands out to me is personality conflict. In any healthcare organization there are multiple people with different personalities. In a hospital for example you have the support staff, the clinical staff, the physicians, the managers and then upper management to name a few. All want very specific things and outcomes and these can clash at times. There are also different personalities that come into play as well. There are those that are very passive and just complete the tasks that they are told if if they don’t believe that they are right. There are those that are more middle of the road that will speak out if they feel passionately or strongly about something. Then there are those at want to questions everything or believe that they are right no matter what all time. There are also varying degrees in between. This is where conflict can arise when you have multiple people caring for a patient and believe what they are doing is right and what is best for the patient. The nurse leader will be looked to to help manage conflict and bring about resolution. There are multiple strategies that the nurse leader can use to bring about resolution. The of the more common are compromise, collaboration and mediation. The nurse leader can help facilitate any of these methods of conflict resolution. They can help one or both parties assess what is needed and how a compromise of the two ideas or plans can be reached. The nurse leader can suggest collaboration with the two parties that they may work on the specific problem together and bring together their ideas into a unified solution. The nurse leader can also be a mediator between the two sides if compromise and or collaboration do not prove successful. They can help guide the two parties to come to an agreement and work on unified front. The model that would be effective in addressing conflict is transformational leadership. This type of leadership “connects with shared values, involved with he team, inspires, motivates, and empowers others to reach a shared vision.” (Smith and Johnson, 2018) This theory would easily lend itself to conflict resolution. This theory focuses on the team aspect and shared values. By having that as a focus point the nurse leader can adapt to different situations and help to resolve conflict with the best outcome possible because it for the betterment of the team and the patient. Word count: 422 Lahana, E., Tsaras, K., Kalaitzidou, A., Galanis, P., Kaitelidou, D., & Sarafis, P. (2017). Conflicts management in public sector nursing. International Journal of Healthcare Management, 12(1), 33–39. https://doi.org/10.1080/20479700.2017.1353787 Smith, C. & Johnson, C. (2018). Preparing Nurse Leaders in Nursing Professional Development. Journal for Nurses in Professional Development, 34 (1), 38-40. doi: 10.1097/NND.0000000000000404.NUR 514 Topic 3: Organizational Change Theories And Strategies
Objectives:- Discuss the advanced registered nurse’s role as change agent within the interprofessional health care environment.
- Analyze factors driving organizational change within health care organizations.
- Evaluate change theories and collaborative models for promoting change.
- Evaluate the ethical, social, legal, economic, and political implications of practice change.
Resources
Collapse All ResourcesCollapse All Advanced Practice Nursing: Essential Knowledge for the Profession Read Chapter 5 in Advanced Practice Nursing: Essential Knowledge for the Profession. Review Chapter 7. View ResourceLeadership in Nursing Practice: Changing the Landscape of Health Care Read Chapter 1 in Leadership in Nursing Practice: Changing the Landscape of Health Care. View Resource
Loom Loom is a free video recording tool that allows you send messages through shareable videos. For assistance on installing the softwa … Read More https://support.gcu.edu/hc/e
Topic 3 DQ 1
Describe an organizational change model that can be used in a dynamic health care environment. Based on this model, how is organizational change is managed? What role do stakeholders play during organizational change?Topic 3 DQ 1 Example Solution
An organizational change model that can be used in a dynamic health care environment is Lewin’s Change Model. Organizational change is managed in this model by using three stages. The first stage is the unfreezing stage. During this stage, practices that need improvement and understanding the current practices and why they are completed this way. It is also the time to identify “any barriers that would prevent changes.” (El-shafy, Zapke, Sargeant, Prince & Christopherson 2019). Once this stage is completed, the second phase of Lewin’s Change Model can begin. The second stage is the moving stage. Using the motivation from the previous stage, leaders can keep the change in motion. This stage allows leaders to work towards the goal of the change. The final stage of the model is the refreezing stage. The leader uses positive reinforcement to prevent staff from going back to the old ways of doing things. This promotes the continuing use of the change to improve the workplace. An example of this on my current unit is the goal of decreasing telemetry calls for leads off a patient. The leaders decided that the calls were time consuming and would prevent the monitors from being able to call during an emergency. The leaders discussed this problem with staff of both the unit and telemetry and obtained processes for each unit and telemetry units. This unfreezing stage was able to take place. The leaders took the obtained information and created a change that would decrease the amount of calls for both telemetry and the unit. The leaders then presented the change that would occur and thus began the moving stage. Nurses and technicians worked together to change the telemetry stickers on each patient at noon and midnight. Batteries were also to be changed once per shift by nine in the morning and nine at night. These changes in the moving stage have then undergone the refreezing state. The new employees are learning this process as part of the daily tasks. The leaders provided positive reinforcement every time the goal was met for the telemetry calls. This process is now completed and working well to decrease telemetry calls. Stake holders play a supportive role during organizational change. The stakeholders may sometimes have opinions or goals of their own. Stakeholders can relay the goals they would like to the leaders who then can begin a process for organizational change. The leaders can use Lewin’s Change Model to achieve these goals set by the stakeholders. Word Count: 408Reference:
El-shafy, I. A., Zapke, J., Sargeant, D., Prince, J. M., & Christopherson, N. A. M. (2019). Decreased Pediatric Trauma Length of Stay and Improved Disposition With Implementation of Lewin’s Change Model. Journal of Trauma Nursing, 26(2), 84–88.Topic 3 DQ 1 Example Solution 2
The organizational change model that stands out to me is the Complexity Theory. “Complexity is defined as the measure of heterogeneity or diversity in internal and environmental factors such as departments, customers, suppliers, socio-politics, and technology (Mason 2007: 10). Complexity theory focuses on how parts at a micro-level in a complex system affect emergent behavior and overall outcome at the macro-level.” (Amagoh, 2008). This theory is very applicable to the healthcare environment. A large healthcare institution is made of diverse people, jobs, roles, and patients, therefore, in order for the institution to grow, it must be able to change at the micro-level to influence change at the macro-level. Implementing this theory, with the influence of Transformational Leadership Theory, has the potential to empower people at all levels of the company with the common larger goal of the institution. The interconnection of these two theories, both a change theory and a leadership theory, allows for the leaders of each department to become stakeholders for the entire institution. Establishing key stakeholders is incredibly important for change. Creating a diverse team from multiple disciplines allows for a greater potential for change because of the trust and relationship building between the team. Having a change team that is cohesive in nature, allows for the perception of people on the outside of that team, who ultimately must support the change, to view the team as trustworthy. (DeNisco, 2019). The stakeholders must also be invested in the evaluation of the change. Often times when change is inspired, the excitement is at the beginning of the process and then starts to fade over time. However, after the change is implemented, it is imperative to evaluate the result and modify it as needed. Being a change agent is empowering and inspiring, but the commitment that it takes is sometimes overlooked. Word Count 302 Amagoh, F. (2008). Perspectives on Organizational Change: Systems and Complexity Theories. Innovation Journal, 13(3), 31–44. DeNisco, S. M. (2019). Advanced practice nursing (4th ed.). Jones & Bartlett Learning.Topic 3 DQ 2
You have been selected to serve on a community outreach committee within your state’s nursing organization. The committee includes registered nurses of different specialties. At your first meeting, it becomes evident that not everyone is in agreement with a recent position statement about the role of spiritual care, with some members arguing they will no longer support the committee if the position statement is not revised or reversed. As a nurse leader and change agent, how would you approach the committee? How could you draw from change theory to address these concerns and encourage collaboration on the committee?Topic 3 DQ 2 Example Solution
The nurse leader acts as a change agent by developing strategies for innovation and change. A nurse leader strives to contribute positive changes to the profession of nursing to improve patient outcomes (Helbig, 2018). Conflict may occur because of change. Conflict management strategies are integral skills for the nurse leader. A simple strategy is education of the team. Informing others as to why change is necessary in advance of the action is a positive approach that often will circumvent the conflict that may arise if change is not managed well. Focusing on most team members that support the change, while continuing to educate and listen to those that do not support change, will foster a dialogue of understanding of the resistance (Weberg, Mangold, Porter-O’Grady, & Malloch, 2019). This is a key strategy to building a team. Team member acceptance rather than the potential for sabotage is a direct result of understanding why change is occurring. Managing change through the organization correctly enhances the potential for organizational success. One strategy to implement change is to involve the individuals who are impacted. An interactive change management approach rather than a reactive approach when confronted with change is preferred (Thomas, 2018). Leaders who create a culture that encourages a team to challenge the existing environment will seldom face the need for redesign, because the constant assessment for change will lead to a progressive organization. Utilizing change theory to nurture team collaboration would begin with establishing the need for change, providing a background of evidence for the situation that requires a change. This process is then followed by rationale and goals for the initiative (Nilson, Seing, Ericsson, Birken, & Schildmeijer, 2020). Providing a reason for the change and the importance of it, gathering the right people from the interprofessional team to escalate the change, developing core values, mission statement, and strategies, and providing for an understanding of the change should occur at the first meeting.References:
Helbig, J. (2018). Reengineering health care management. Nursing Leadership and Management: Leading and Serving. Ch. 5. Retrieved from https://lc.gcumedia.com/nrs451vn/nursing-leadership-and[1]management-leading-and-serving/v1.1/#/chapter/5 Nilsen, P., Seing, I., Ericsson, C., Birken, S. A., & Schildmeijer, K. (2020). Characteristics of successful changes in health care organizations: an interview study with physicians, registered nurses, and assistant nurses. BMC Health Services Research, 1, 1. https://doi-org.lopes.idm.oclc.org/10.1186/s12913-020- 4999-8 Thomas, J. S. (2018). Organizational culture and values. Nursing Leadership and Management: Leading and Serving. Ch. 4. Retrieved from https://lc.gcumedia.com/nrs451vn/nursing-leadership-and[1]management-leading-and-serving/v1.1/#/chapter/ Weberg, D., Mangold, K., Porter-O’Grady, T., & Malloch, K. (2019). Leadership in Nursing Practice: Changing the landscape of health care (3rd Ed.). Burlington, MA: Jones & Bartlett Learning.Topic 2 APA Assignment: Leadership Style Reflective Essay
Assessment Description The purpose of this assignment is to assist learners in developing effective communication by emphasizing the proper application of APA style. APA style is required for the graduate program. Refer to the resources in the Class Resources and Student Success Center for assistance with APA. Use the APA Style Guide resource, located in the Student Success Center, to complete this assignment. For this assignment, complete the following: Self-Assessment Self-awareness is essential for developing leadership skills. Recognizing your own strengths, weaknesses, and values, and understanding emotional intelligence and learning styles can help you to be a more effective nurse leader. For this assignment, you have the opportunity to take a variety of self-assessments to learn more about yourself and identify your assets and weaknesses as a leader. This will assist you in discovering how you can improve your own self-leadership skills. You will be asked to think critically about your results and submit a reflection as directed below. Refer to the topic Resources. Select and complete three self-assessments. Be sure to document the results of each assessment to assist you in completing the reflection portion of the assignment below. Self-Assessment Reflection Becoming self-aware is an ongoing process requiring introspection. The more often people practice self-reflection, the more opportunities they have to understand their own behaviors and adapt their approaches to working with other people, which can improve both your own and other’s abilities to meet their professional goals. In a 1,000-1,250 word reflective essay, address the following:- Provide a rationale and brief summary for selecting each self-assessment. Summarize the results you obtained on each assessment.
- Identify the leadership style that closely aligns to your philosophy of care and explain what appeals to you about that style.
- Reflect on how you might incorporate elements of that particular style as you exercise leadership in a practice or health care organization setting.
- Discuss any particular areas for improvement the assessments helped you identify and some steps for improving your leadership capabilities.
- Analyze the characteristics of an effective professional nurse leader, or individuals in nursing leadership. Discuss the characteristics and explain why they are effective for leadership in nursing.
- Analyze different leadership theories and leadership styles. Select one theory and leadership style, different from your own, and explain how they each support a professional nurse leader or individual in nursing leadership. Consider how the theory shapes the nurse leader in such things as collaboration, conflict resolution, decision making, and negotiation.
Rubric Criteria
Collapse All Rubric CriteriaCollapse All Summary of Self-Assessment Selections and Results 6.25 points Criteria Description Summary of Self-Assessment Selections and Results 5. 5: Excellent 6.25 points A comprehensive summary of why each self-assessment was selected and the results obtained on each assessment is thoroughly developed with supporting details. 4. 4: Good 5.75 points A summary of why each self-assessment was selected and the results obtained on each assessment is clearly provided and well developed. 3. 3: Satisfactory 5.5 points A summary of why each self-assessment was selected and the results obtained on each assessment is present. 2. 2: Less Than Satisfactory 5 points A summary of why each self-assessment was selected and the results obtained on each assessment is present, but it lacks detail or is incomplete. 1. 1: Unsatisfactory 0 points A summary of why each self-assessment was selected and the results obtained on each assessment is not included. A Specific Leadership Style That Aligns With Philosophy of Care, Including Appeal 6.25 points Criteria Description A Specific Leadership Style That Aligns With Philosophy of Care, Including Appeal 5. 5: Excellent 6.25 points A comprehensive discussion of a specific leadership style that aligns with philosophy of care, including appeal, is thoroughly developed with supporting details. 4. 4: Good 5.75 points A discussion of a specific leadership style that aligns with philosophy of care, including appeal, is clearly provided and well developed. 3. 3: Satisfactory 5.5 points A discussion of a specific leadership style that aligns with philosophy of care, including appeal, is present. 2. 2: Less Than Satisfactory 5 points A discussion of a specific leadership style that aligns with philosophy of care, including appeal, is present, but it lacks detail or is incomplete. 1. 1: Unsatisfactory 0 points A discussion of a specific leadership style that aligns with philosophy of care, including appeal, is not included. Reflection on How to Incorporate Elements of the Leadership Style 6.25 points Criteria Description Reflection on How to Incorporate Elements of the Leadership Style 5. 5: Excellent 6.25 points A comprehensive reflection on how to incorporate elements of the leadership style is thoroughly developed with supporting details. 4. 4: Good 5.75 points A reflection on how to incorporate elements of the leadership style is clearly provided and well developed. 3. 3: Satisfactory 5.5 points A reflection on how to incorporate elements of the leadership style is present. 2. 2: Less Than Satisfactory 5 points A reflection on how to incorporate elements of the leadership style is present, but it lacks detail or is incomplete. 1. 1: Unsatisfactory 0 points A reflection on how to incorporate elements of the leadership style is not included. Areas for Self-Improvement, Including Steps to Improve Leadership Capabilities 6.25 points Criteria Description Areas for Self-Improvement, Including Steps to Improve Leadership Capabilities 5. 5: Excellent 6.25 points A comprehensive discussion of areas for self-improvement, including steps to improve leadership capabilities, is thoroughly developed with supporting details. 4. 4: Good 5.75 points A discussion of areas for self-improvement, including steps to improve leadership capabilities, is clearly provided and well developed. 3. 3: Satisfactory 5.5 points A discussion of areas for self-improvement, including steps to improve leadership capabilities, is present. 2. 2: Less Than Satisfactory 5 points A discussion of areas for self-improvement, including steps to improve leadership capabilities, is present, but it lacks detail or is incomplete. 1. 1: Unsatisfactory 0 points A discussion of areas for self-improvement, including steps to improve leadership capabilities, is not included. Characteristics of Effective Professional Nurse Leader 6.25 points Criteria Description Characteristics of Effective Professional Nurse Leader 5. 5: Excellent 6.25 points Characteristics of an effective professional nurse leader, or individuals in nursing leadership, are thoroughly discussed. A detailed explanation for why these are effective for leadership in nursing is clearly presented. 4. 4: Good 5.75 points Characteristics of an effective professional nurse leader, or individuals in nursing leadership, are discussed. An explanation for why these are effective for leadership in nursing is presented. 3. 3: Satisfactory 5.5 points Characteristics of an effective professional nurse leader, or individuals in nursing leadership, are summarized. An explanation why these are effective for leadership in nursing is outlined. 2. 2: Less Than Satisfactory 5 points Characteristics of an effective professional nurse leader, or individuals in nursing leadership, are only partially discussed. 1. 1: Unsatisfactory 0 points Characteristics of an effective professional nurse leader, or individuals in nursing leadership, are not discussed. Application of Leadership Theory and Style Different Personal Style 6.25 points Criteria Description Application of Leadership Theory and Style Different Personal Style 5. 5: Excellent 6.25 points A different theory and leadership style, and how they support a professional nurse leader, or individual in nursing leadership are clearly explained. How the theory shapes the nurse leader in such things as collaboration, conflict resolution, decision making, and negotiation is thoroughly discussed. 4. 4: Good 5.75 points A different theory and leadership style, and how they support a professional nurse leader, or individual in nursing leadership are explained. How the theory shapes the nurse leader in such things as collaboration, conflict resolution, decision making, and negotiation is generally discussed. 3. 3: Satisfactory 5.5 points A different theory and leadership style, and how they support a professional nurse leader, or individual in nursing leadership are summarized. How the theory shapes the nurse leader in such things as collaboration, conflict resolution, decision making, and negotiation is outlined. 2. 2: Less Than Satisfactory 5 points A different theory and leadership style, and how they support a professional nurse leader, or individual in nursing leadership, are only partially discussed. 1. 1: Unsatisfactory 0 points A different theory and leadership style, and how they support a professional nurse leader, or individual in nursing leadership, are omitted. Required Sources 6.25 points Criteria Description Required Sources 5. 5: Excellent 6.25 points Number of required resources is met. Sources are current, and appropriate for the assignment criteria and nursing content. 4. 4: Good 5.75 points Number of required sources is met. Sources are current, but not all sources are appropriate for the assignment criteria and nursing content. 3. 3: Satisfactory 5.5 points Number of required sources is met, but sources are outdated or inappropriate. 2. 2: Less Than Satisfactory 5 points Number of required sources is only partially met. 1. 1: Unsatisfactory 0 points Sources are not included. Title Page 6.25 points Criteria Description Title Page 5. 5: Excellent 6.25 points The title page is presented. The required format is applied correctly. There are no errors. 4. 4: Good 5.75 points The title page is presented. The required formatting is applied, although there may be one or two errors. 3. 3: Satisfactory 5.5 points The title page is presented. The required formatting is applied but there are minor errors. 2. 2: Less Than Satisfactory 5 points The title page reflects some required formatting, but overall it is not correctly applied. 1. 1: Unsatisfactory 0 points The title page is not formatted according to required style. The title page is omitted. Introduction 12.5 points Criteria Description Introduction 5. 5: Excellent 12.5 points The introduction is presented. The required formatting is applied correctly. There are no errors. 4. 4: Good 11.5 points The introduction is presented. The required formatting is applied, although there may be one or two errors. 3. 3: Satisfactory 11 points An introduction is presented. The required formatting is applied but there are minor errors. 2. 2: Less Than Satisfactory 10 points An introduction is presented but the overall required formatting is not consistently or correctly applied. 1. 1: Unsatisfactory 0 points The introduction is not presented in required format. The introduction is omitted. Main Body 18.75 points Criteria Description Main Body 5. 5: Excellent 18.75 points The sections of the main body are organized to reflect the main points of the author. The required formatting is applied correctly. There are no errors. 4. 4: Good 17.25 points The sections of the main body are clear. The required formatting is applied, although there may be one or two errors. 3. 3: Satisfactory 16.5 points The sections of the main body are generally identifiable. The required formatting is applied but there are minor errors. 2. 2: Less Than Satisfactory 15 points The main body is disorganized. Overall, the required formatting is not consistently or correctly applied. 1. 1: Unsatisfactory 0 points The required formatting is not used for the main body. APA Style Citations 12.5 points Criteria Description APA Style Citations 5. 5: Excellent 12.5 points All sources are cited. The required style and format are correctly applied and are free from error. 4. 4: Good 11.5 points All sources are cited. The required style and format are applied and mostly correct. There may be one or two errors. 3. 3: Satisfactory 11 points Most sources are cited. One may be missing. The required style and format are typically applied. Some errors are present. 2. 2: Less Than Satisfactory 10 points Citation of sources is incomplete. The use of the required style for citation of sources is inconsistent and incorrect. 1. 1: Unsatisfactory 0 points Sources are not cited throughout. The required style is not used for citations. Sources are not included. Appendix 6.25 points Criteria Description Appendix 5. 5: Excellent 6.25 points The APA Writing Checklist is complete and attached in the appendix. The required formatting is applied correctly. There are no errors. 4. 4: Good 5.75 points The APA Writing Checklist is complete and attached in the appendix. The required formatting is applied, although there may be one or two errors. 3. 3: Satisfactory 5.5 points The APA Writing Checklist is complete and attached in the appendix. The required formatting is applied but there are minor errors. 2. 2: Less Than Satisfactory 5 points The APA Writing Checklist is attached in the appendix but is incomplete. The appendix reflects some of the required formatting, but overall it is not correctly applied. 1. 1: Unsatisfactory 0 points The appendix is not formatted according to the required style. The appendix and APA Writing Checklist are omitted. References 6.25 points Criteria Description References 5. 5: Excellent 6.25 points Sources are completely and correctly documented on a References page, as appropriate to assignment and the required style, and format is free of error. 4. 4: Good 5.75 points Sources are documented on a References page, as appropriate to assignment and the required style, and format is mostly correct. 3. 3: Satisfactory 5.5 points The APA Writing Checklist is complete and attached in the appendix. The required formatting is applied but there are minor errors.Sources are documented on a References page, as appropriate to assignment and the required style, although some formatting errors may be present. 2. 2: Less Than Satisfactory 5 points Documentation of sources using a References page is inconsistent or incorrect, as appropriate to assignment and the required style, with numerous formatting errors. 1. 1: Unsatisfactory 0 points Sources are not documented. A References page is not included. Thesis Development and Purpose 12.5 points Criteria Description Thesis Development and Purpose 5. 5: Excellent 12.5 points Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear. 4. 4: Good 11.5 points Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose. 3. 3: Satisfactory 11 points Thesis is apparent and appropriate to purpose. 2. 2: Less Than Satisfactory 10 points Thesis is insufficiently developed or vague. Purpose is not clear. 1. 1: Unsatisfactory 0 points Paper lacks any discernible overall purpose or organizing claim. Mechanics of Writing (includes spelling, punctuation, grammar, and language use) 6.25 points Criteria Description Mechanics of Writing (includes spelling, punctuation, grammar, and language use) 5. 5: Excellent 6.25 points The writer is clearly in command of standard, written, academic English. 4. 4: Good 5.75 points Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech. 3. 3: Satisfactory 5.5 points Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed. 2. 2: Less Than Satisfactory 5 points Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied. 1. 1: Unsatisfactory 0 points Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is employed.Topic 3 Assignment Implementing Change With an Interprofessional Approach Presentation
Assessment Description As an advanced registered nurse, you will serve as a leader within your organization. Part of this role will entail being a change agent and spurring positive change on behalf of patients, colleagues, and the industry. Consider a situation you experienced previously where change did not go as planned in your health care organization. Create a 10-15-slide PowerPoint presentation in which you will assess the situation and the steps that should have been taken to successfully implement change. Create speaker notes of 100-250 words for each slide. Include an additional slide for the title and references. For the presentation of your PowerPoint, use Loom to create a voice-over or a video. Refer to the topic Resources for additional guidance on recording your presentation with Loom. Include an additional slide for the Loom link at the beginning and another at the end for References. Include the following in your presentation:- Describe the background of the situation and the rationale for and goal(s) of the change. Consider the ethical, social, legal, economic, and political implications of practice change in your response.
- Outline the advanced registered nurse’s role as change agent within the interprofessional and dynamic health care environment.
- Identify the key interprofessional stakeholders (both internal and external) that should be involved in change efforts.
- Discuss an appropriate change theory or model that could be used to achieve results. Explain why the theory or model selected is best for the situation. Include the ethical, social, legal, economic, and political implications of applying the change management strategies to practice change in your response.
- As an advanced registered nurse, outline how you would initiate the change.
- Describe the impact to the organization if the change initiative is unsuccessful again, and potential steps the interprofessional team could take if the change is unsuccessful.
- Predict what additional factors will drive upcoming organizational change for the organization and outline the advanced registered nurse’s role as change agent.
NUR 514 Topic 4: Nurse Leadership And Health Care Policy And Advocacy
Objectives:- Propose strategies to support patient advocacy in health care policy making as an advanced practice nurse.
- Analyze the impact health care policy on health care organizations and cost-effective quality care.
Resources
Collapse All ResourcesCollapse All Advanced Practice Nursing: Essential Knowledge for the Profession Review Chapter 23 in Advanced Practice Nursing: Essential Knowledge for the Profession. View ResourceLeadership in Nursing Practice: Changing the Landscape of Health Care Read Chapters 11 and 13-15 in Leadership in Nursing Practice: Changing the Landscape of Health Care. View Resource
Preparing Nurses for Leadership in Public Policy Read “Preparing Nurses for Leadership in Public Policy” (2014), located on the Robert Wood Johnson Foundation website. http://www.rwjf.org/en/library/articles-and-news/2014/02/preparing-nurses-for-leadership-in-public-policy.html
Arizona State Legislature Explore your state legislature website and access legislation information. The link to the Arizona State Legislature website is provided, … Read More http://www.azleg.gov/
Consumer Information and Insurance Oversight Read “Consumer Information and Insurance Oversight,” located on the Programs and Initiatives page of the Centers for Medicare and … Read More https://www.cms.gov/cciio/index
Guide to Healthcare Reimbursement Models Read “Guide to Healthcare Reimbursement Models,” located on the DECO Recovery Management website (2019). https://www.decorm.com/guide-to-healthcare-reimbursement-models/
Understanding the Value-Based Reimbursement Model Landscape Read “Understanding the Value-Based Reimbursement Model Landscape,” by LaPointe (2020), located on the Revcycle Intelligence webs … Read More https://revcycleintelligence.com/features/understanding-the-value-based-reimbursement-model-landscape
Generational Differences and Professional Memberships Read “Generational Differences and Professional Memberships,” by Martin and Waxman, from Nurse Leader (2017). https://www-sciencedirect-com.lopes.idm.oclc.org/science/article/pii/S1541461216302622
Differences and Importance of IPPS, OPPS, MPFS and DMEPOS Read “Differences and Importance of IPPS, OPPS, MPFS and DMEPOS,” located on the NursingAnswer.net website. https://nursinganswers.ne