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NURS 4550 > Class 5 - HCO > Flashcards

Class 5 - HCO Flashcards

1
Q

define health care organization, according to Keller

A

a purposefully designed, structured social system developed for the delivery of health services by specialized workforces to defined communities, populations or markets

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2
Q

How do HCO look like when run as a social system?

A
  • created by the people
  • managed by the people
  • for the people
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3
Q

What the 3 categories the make up a HCO?

A
  • focus of mission
  • financial classification
  • ownership
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4
Q

Describe HCO focus of the mission

A
  • The purpose of HCO is determine the organization’s mission, vision, and values
  • Mission statements issued by HCOs describe each organization’s purpose based on a vision of what the HCO is meant to achieve
  • ex: research, education OR specialty, community
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5
Q

Describe HCO financial classification

A

Either for-profit or not-for-profit entities
- For-profits are designed to generate profits for shareholders while also providing healthcare services
- Not-for-profit also generate profit, but these are used for organizational purposes, such as building additional facilities, providing improved services, or acquiring new equipment (break-even often)

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6
Q

Describe the HCO ownership

A
  • Publicly: organizations that are supported by the government funding. (ex: tax-supported county or state hospital that provides generalized healthcare services or specific health services/ state and local public health departments)
  • Privately: not generally supported by public funding (ex: investor-owned corporations/ HCO owned religious or social organizations)
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7
Q

What are the major defining attributes of HCO

A
  • purpose
  • specialized healthcare workforce
  • public trust
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8
Q

What are the minor defining attributes of HCO

A
  • structure
  • organizational environments
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9
Q

HCO major attributes, purpose

A
  • to help others, regardless of the profit status of the ownership arrangements
  • is determined by the organization’s mission, vision, and values
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10
Q

HCO major attributes, specialized services

A
  • provide highly specialized care
  • have a highly specialized workforce
  • provide care that is complex with a narrow margin for error
  • have little tolerance for errors or mistakes that are potentially life-threatening or costly
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11
Q

HCO minor attributes, structure

A
  • The collective of formal rules and policies that govern organizational practises
  • promote the effective management of materials and resources
  • creates various roles in associated responsibilities that are required for organizational function
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12
Q

HCO minor attributes, organizational environments

A

Possess in an internal environment, but also interact with an external environment
- Internal: integrated web factors such as organizational culture (culture: set of values, beliefs, and practices), systems such as information systems or the human resources management system, and structural elements such as role responsibilities, rules, and practises
- External: external forces, conditions, or events that affect the organization, such as economic trends or new laws and government regulations (ex: widespread economic recession and government funding changes that affect HCOs)

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13
Q

What are the theoretical links to HCO

A
  • bureaucracy
  • complex adaptive system
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14
Q

HCO, describe a bureaucracy

A
  • machinelike collection of components to be coordinated
  • administrative concept embedded in how organizations are structured
  • closed system
  • authority & control gets results
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15
Q

Bureaucracy, method to determine extent:

A
  • labour specialization
  • centralization
  • formalization
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16
Q

HCO, describe complex adaptive system

A
  • affected by outside forces
  • social system
  • employees innovate & are engaged
    -have the ability to react and change when stimulated
  • are responsive to changing trends
  • transform, adapt, and adjust as needed
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17
Q

What are interrelated concepts for HCO

A
  • leadership
  • power
  • learning organizations
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18
Q

HCO, context to nursing

A
  • as largest healthcare workforce , nurses are found in nearly all health care organizations
  • nurses provide the knowledge and skills necessary for delivery of services
  • the multiple roles that nurses play are found in HCO
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19
Q

What needs to be know when analyzing organizations

A
  • organizational structure
  • organizational culture
  • reporting relationships
  • recruitment practices
  • method of selecting individuals for positions
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19
Q

What are the different types of structures in a HCO

A
  • functional
  • service line
  • matrix
  • flat
  • shared governance
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20
Q

Describe functional structure

A
  • Arranged apartments and services according to specialty
  • Common in healthcare organizations
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21
Q

What the benefits of functional structure

A
  • supports professional expertise
  • encourage advancement
22
Q

What the limitations of functional structure

A
  • results in discontinuity of patient care services
  • delays in decision-making can occur if a silo mentality develops within groups; (issues that require communication across functional groups typically must be raised with senior management level before decision can be made)
23
Q

Describe flat structure

A
  • Delegation of decision-making to the professionals doing the work
  • signifies the removal of hierarchal layers, thereby granting authority to act and placing authority at the action level
  • Less formalized than hierarchal organizations
24
Q

What are the benefits of flat structure

A
  • communication
  • decrease in strict adherence to rules and policies
  • decentralized
  • employees make individualized decisions that fit specific situation and meet the needs created by the increasing demands (autonomy)
25
Q

What are the limitation of flat structure

A
  • potential for inconsistent decision-making
  • loss of growth opportunities
  • need to educate managers to communicate effectively and demonstrate creativity in working within these nontraditional structures
26
Q

Describe service line structure

A

The functions necessary to produce a specific service or product brought together into an integrated organizational unit under the control of a single manager or executive

27
Q

What are the benefits of service line structure

A
  • coordination of services
  • an expedited decision making process
  • clarity of purpose
28
Q

What are limitations of service line structure

A
  • increased expenses associated with the duplication of services server
  • loss of professional or technical affiliation
  • lack of standard ovation
29
Q

Describe Matrix structure

A
  • Complex and design to reflect both function and service in an integrated organizational structure
  • The manager of a unit responsible for a service reports to both a functional manager and they service- or product- line manager
  • Combination of both a bureaucratic structure and a flat structure
30
Q

What are some benefits of matrix structure

A
  • enables timely response to forces in the external environment that demand continual programming
  • facilitates internal efficiency and effectiveness through the promotion of cooperation among disciplines
  • permit better cross communication among various organizational units or departments
  • may serve to flatten simplified decision-making structures and allow for a timely and quality response to change initiated by factors outside the control of the organization
31
Q

What are some limitations of matrix structure

A
  • can lead to some dispersion of accountability and potential conflict as some employees may report to more than one supervisor
  • may lead to an increase in bureaucracy, in the form of more meetings or slower decisions were too many people are involved
32
Q

Define organizational culture, according to Ravasi & Shultz

A

a set of shared mental assumptions that guide interpretation and action in organizations by defining appropriate behaviour for various situations

33
Q

What are key factors in an organizational culture

A
  • SHOULD reflect mission, vision, values
  • reflects norms & traditions of unit or HCO
  • socially constructed
  • difficult to change
  • can promote harmony or disharmony
34
Q

What is a mission statement

A
  • a formal written document that identifies the organizations unique purpose; it’s core values/the patients served/the types of programs or services offered such as education, support of nursing care, rehab, acute care, home care
  • Set the stage by defining the services to be offered which intern identify the kinds of technologies and human resources to be employed
  • Typically refers to the larger community the organizations serve as well as the specific patient populations to whom they provide care
35
Q

What is a vision statement

A

Reflected to the community
- Future oriented, purposeful statements designed to identify the desired future of an organization
- They serve to unify all subsequent statements toward the view of the future and to convey the core message of the mission statement
- Typically are brief, consisting of only one or two phrases or sentences

36
Q

What is a philosophy

A

Reflected in organizational structure
- A written statement that articulates the values and beliefs held about the nature of the work required to accomplish the mission and the nature and rights of both the people being served and those providing the service
- Philosophies are evolutionary in that they are shaped both by the social environment and by the stage of development of professionals delivering the services

37
Q

What happens when we added value statements in a HCO

A
  • work life & relationships: bringing collaboration & teamwork to all that we do
  • care & passion: taking pride in providing safe, high quality care to the populations we serve
38
Q

What influence creating mission, vision, and values of an HCO

A
  • participants
  • outside forces
  • technology
  • resources
39
Q

What are nursing care models selections based on?

A
  • patient population
  • size of organization and/or unit
  • staffing mix and numbers
  • budget
40
Q

What are the types of nursing care models

A
  • total patient care (case method)
  • functional nursing
  • team nursing
  • primary nursing
41
Q

Describe total patient care

A
  • 1-to-1 care; premise of the case method is that one nurse provides total care for one patient during the entire work period
  • ## used in critical care settings
42
Q

What are the advantages of total patient care

A
  • patient-centred
  • comprehensive
  • builds rapport + trust
  • holistic
  • better relationship with patient
43
Q

What are disadvantages of total patient care

A
  • expensive (increased cost)
  • need efficient communication (between RN)
44
Q

Describe functional nursing

A
  • most common; used when there is a shortage of staff
  • each regulated and unregulated member of the care team performs specific tasks for a large group of patients
  • tasks are determined by scope of practice defined for each type of caregiver
  • staff may view as autocratic
45
Q

What are advantages of functional nursing

A
  • large number of tasks in short period
  • unregulated person can be trained to one specific task
  • organization benefits financially; cost-effective o mix staff
  • works well in emergency and disaster situations
  • common in sub-acute, extended care, and ambulatory clinics
46
Q

What are disadvantages of functional nursing

A

risk a decrease in patient satisfaction:
- fragmentation of care (things can be missed)
- confuse more patients (due to various staff per shift)
- ineffective, poo communication among staff (no over-see)
- less control of quality

47
Q

Describe team nursing

A
  • modification of functional nursing
  • used when nursing shortages have resulted in organizations changing the staff mix + increasing ratio of unregulated to regulated care providers
  • nurse team leader is responsible for coordinating a group of personal (highly skilled leader, manager, and practitioners
  • members of team report to team leader, team leader report to charge nurse or unit manager
48
Q

What are advantages of team nursing

A
  • improved patient satisfaction
  • decision making by staff nurses (enhances satisfaction)
  • cost-effectiveness for employer
49
Q

What are disadvantages of team nursing

A
  • poor leadership skills = bad outcomes (need good communication skills, delegation and conflict-management abilities, strong clinical skills, effective decision-making)
  • high responsibility (for team lead)
50
Q

Describe primary nursing

A
  • adaption of case method
  • one nurse functions autonomously as the patient’s primary nurse throughout the hospital stay
  • Primary nurse responsible for planning and delivering care to consistent group of patients (accountable for patients’ care 24hr/day from admin to d/c)
  • care organized using nursing process (assess, diagnosis, plan, implement)
51
Q

What are advantages to primary nursing

A
  • increase communication with other HCP
  • increase pt rapport
  • works with professional staff
  • autonomy
  • motivation
  • holistic care
  • increased quality care and patient satisfaction (study shows)
52
Q

What are disadvantages to primary nursing

A
  • costly for agency
  • RN may not want 24-hour responsibility
  • RN may be inexperienced and lack autonomy; required specialized knowledge

NURS 4550 (13 decks)

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