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Leadership > Exam 2 > Flashcards

Exam 2 Flashcards

0
Q

Effective Communication Needs

A
  • Trust
  • Respect
  • Empathy
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1
Q

What is communication?

A
  • The process of transmitting info., perception, and understanding from person to person
  • The art of being able to structure & transmit a message in a way that another can understand easily & accept message
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2
Q

What four necessary elements are needed for humanizing communication?

A
  • Trust
  • Self-disclosure
  • Feedback
  • Listening
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3
Q

Low Context Communication

A

Explicit verbal or written messages

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4
Q

High-context Communication

A
  • Understand, reading between the lines
  • Hard to navigate for outsider
  • subculture: healthcare
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5
Q

What are some major barriers to quality health care r/t health illiteracy?

A
  • Accessing care
  • Illness management
  • General information processing
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6
Q

Facts about people with low health literacy

A
  • 1.5-3 x more likely to have adverse outcomes
  • MEdicare enrollees have a greater chance of NEVER having a Pap smear
  • Associated w. increased risk for hospitalization
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7
Q

The Joint Commission 2007

A
  • create patient-centered environments where the pt. is involved in decision-making & safety processes
  • Increase awareness & understanding of hlth literacy
  • Understand how comm. affects QOC
  • Review & improve informed consent materials & processes
  • Develop cultural competence
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8
Q

Standard Hand-off communication

A

SBAR

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9
Q

Committee

A

Stable group, meet periodically, have identified purpose

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10
Q

Team

A

A Small number of people committed to a common purpose

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11
Q

Team nursing

A

Not a “true team” since members vary shift-to-shift

Pseudo team

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12
Q

Five dysfunctions of a Team

A
  • Inattention to Results
  • Avoidance of accountability
  • Lack of commitment
  • Fear of Conflict
  • Absence of trust
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13
Q

Elements of an Effective Team

A
  • Purpose
  • Goals
  • Roles
  • Relationships
  • Coordination & Leadership
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14
Q

Purpose

A
  • The leader will be facilitator by helping team members become clear about their reason for gathering
  • State the purpose of the team
  • Create an agenda
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15
Q

Goals

A
  • Establishing goals is a critical stage in team developmetn
  • The leader generally engages the team in establishing goals
  • Clear and specific goals
  • Establish timelines of goals
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16
Q

Roles

A
  • Construct team membership carefully
  • multidisciplinary
  • 4-7 people
  • Minute taker
  • Clear definition of what goals which member is responsible for
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17
Q

Relationships

A
  • Members are required to stay w/in the context of he issues
  • judgment-laced language is not a part of the team’s interaction
  • All participants are expected to contribute fully
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18
Q

Disruptiive group members

A
  • Compulsive
  • Non-talker
  • Interrupters
  • Squashers
  • Busybodies
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19
Q

Coordination & Leadership

A
  • Manage team error & conflict early
  • Meet frequently w/ individuals & the full team to assess progress, confront issues, undertake learning, and measure goal achievement
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20
Q

Four stages of conflict

A
  • Latent: anticipation of conflict
  • Perceived: awareness of conflict, no discussion
  • Felt: Feelings are there (anger, anxiety, stress)
  • Manifest: Overt
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21
Q

Manifest conflict

A
  • Destructive: ignoring policy; avoiding a staff member

- Constructive: Expressing appropriate feeling, encourage the group to identify & solve the problem

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22
Q

Responses to conflict

A
  • Avoidance
  • Accommodation
  • Competition
  • Collaboration
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23
Q

Prevention of conflict

A
  • A staff that cares for themselves (stress is not brought to work)
  • Improve communication
  • Recognize team members as members w expertise
  • clear roles
  • Willing to evaluate team functioning
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24
Q

Clients & family

A
  • Need to avoid taking it personally
  • Safety First- set reasonable limits
  • Active listening
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25
Q

Powerlessness

A
  • Not recongnized
  • Not appreciated
  • Ignored
  • Could lead to lack of initiative or creativity
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26
Q

Power

A
  • Influencing decisions
  • Controlling resources
  • Affecting behavior
  • The power a person has comes from their personal qualities & characteristics
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27
Q

Sources of power

A
  • Legitimate
  • Reward
  • Coercive
  • Referent
  • Expert
  • Informational
  • Persuasive
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28
Q

Empowerment

A

“to empower is to enable to act”

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29
Q

Diversity

A
  • The nurse
  • The patient & family
  • Co-workers
  • The Health Care Institution
30
Q

Cultural Diversity

A

Refers to variation w/ respect to the thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups

31
Q

Multicultural Teams

A

Diversity is a basic component of a strong team

32
Q

Differing styles of communication

A
  • Direct vs. indirect
  • Trouble w/ accents & fluency
  • Differing attitudes toward hierarchy & authority
  • Conflicting norms for decision making
33
Q

Authority

A

Low versus High power distance

34
Q

Becoming culturally competent

A
  • Valuing diversity
  • Making a cultural self-assessmetn
  • Understanding the dynamics when cultures interact
  • Incorporating cultural knowledge
  • Adapting practices to the diversity of the population in the setting
35
Q

Cohorts

A

Members of a generation who are linked through shared life experiences in their formative years

36
Q

Generational markers

A

Events that have an impact on all members of the generation one way or another

37
Q

Generations

A

Mature: 1925-1945
Baby boomers: 1946-1964
Generation X: 1965-1980
Generation Y (millennials): 1981-1999

38
Q

The Baby Boomers

A
  • btwn 1946-1964
  • Dominate U.S. workforce
  • Grown up w/ little economic competition outside the U.S.
  • Efficiency, teamwork, quality, and service have thrived under their leadership
39
Q

Generation X

A
  • Born btwn 1965-1980
  • The first generation of latchkey kids who had to be resourceful at an early age
  • Skeptical of traditional practices & beliefs
  • Strive for a balanced life
40
Q

Attracting a culturally diverse workforce

A
  • Impt. to attract & retain a diverse workforce
  • Impt. for organizations to engender respect for the similarities & differences that employees and clients bring
  • Striving for cultural competence in interpersonal relations
41
Q

Organizational Goals

A
  • Safety
  • Quality of Care
  • Financial stability
  • Increased efficiency
42
Q

Bureaucratic Theory

A
  • Developed during industrialism
  • Merit0 based advancement
  • The workers are obedient & seeking advancement based on performace
  • Goal of management to achieve technical and economic efficiency through rule-bound functioning
43
Q

Scientific Management

A
  • Time & Motion studies

- Econmic incentive to get the highest grade of work from the worker

44
Q

Classical

A
  • A top to bottom method of managing the organization
  • The workers are skilled & specialized technicians
  • Planning & coordination is done by management in a hierarchial division of departments
45
Q

Human Relations

A
  • The social & psychological needs and relationships of worker and groups were thought to be important to work productivity
  • Hawthorne Effect
  • Workers are socially & psychologically motivated `
46
Q

Open System Theory

A
  • Unstable
  • Adaptive, dependent on the environment
  • A system of interdependent activites
  • Uses the contingency theory of mngment
  • There is no single right way to structure an organization
  • The workers are semi-autonomous agents
47
Q

Complex Adaptive Systems

A
  • The ability to continuously & dynamically change when the relationship between the system & its environment shifts or is altered either by action in the relationship or circumstances beyond it.
  • Power is relocated out of the formal structure & is more closely aligned with the point-of-service decision making
  • Short term & responsive action must occur at the point of service
48
Q

Specialization

A
  • The division of work by occupation or function
  • Advantages: improved work performaces, good for complex situations
  • disadvantages: multiple divisions requite coordination
49
Q

Organizational Forms

A
  • Functional: division of work by function or occupation
  • Program: Coordination of work around a service
  • Matrix: A combination of the two
50
Q

Advantages of a Functional Organization

A
  • pros report directly to a discipline-specific supervisor
  • w/in a functional group–>develop social relationships
  • Cost reduction through shared resources
  • Promotion of pro development
51
Q

Disadvantages of a functional organization

A
  • Silo mentality
  • Difficult to establish informal relationships across professions
  • Fragmented care delivery
52
Q

Advantages of program orientation

A
  • optimize service delivery

- Patients can access integrated services from and array of health prs w/ expertise in that program

53
Q

Disadvantages of program orientation

A
  • Pros in a program may not report to a disciplin-specific supervisor
  • Difficult to coordinate services across programs
  • Nurses are isolated from other nurses leading to lack of professional development
  • Processes and procedures are duplicated
54
Q

Matrix Form

A

Function + Program

* Requires dual reporting & additional management

55
Q

Advantages of Matrix Form

A
  • Flexibility to adapt to changes & deliver services because has a varied talent pool
56
Q

Disadvantages matrix form

A
  • Costly

- Dual reporting

57
Q

Organizational Shapes

A

Tall: Mgrs have fewer direct-report staff, the taller, multiple middle mngmnt

Flat: Minimal mngmnt layer

58
Q

Advantages of a Tall organization

A
  • Increased access to mgrs
  • Greater supervisory capability
  • Layers of accountability
59
Q

Advantages of flat organizations

A
  • Streamlining goals, problem-solving, & resources
  • greater hierarchical decentralization
  • Potential for greater staff autonmy
  • greater innovation
  • less costly mgmnt infrastructure
60
Q

Disadvantages of Tall organizations

A
  • more hierarchical centralization
  • Micromanaging
  • slow vertical decisions making
  • lessinnovation
  • costly mgmnt infrastructure
61
Q

Disadvantages of flat organizations

A
  • decreased access to mgrs
  • decreased supervisory capability
  • overextension of mgrs
  • vertical communication delays
62
Q

Authority

A

Hierarchy: bureaucratic & classical structures

Decisions are made in administration & passed down

63
Q

Centralized Management

A
  • Decision making is maintained at the executive level (top–>down)
64
Q

Decentralized management

A
  • Decision making starts at the staff nurse level

- Staff are empowered to make decsions, so fewer levels of mgmnt will be required

65
Q

Shared governance

A

A professional practice model founded on principles of partnership, equity, accountability, ownership (Time Porter-O’Grady)

  • Provides empowerment to nurses–> legitimate power & authority to make decisions regarding their practice
  • developed to address nursing shirtage, high nurse turnover rate & low retention numbers
66
Q

Challenges to Shared governance

A
  • Requires modeling & mentoring by nurse leaders
  • Continual coaching is needed
  • Nurses have traditionally worked in a hierarchial setting
67
Q

Shared decision-making requisites

A
  • At the Point-of-service
  • Stakeholders are involved in their own decisions
  • decisions are made where the work gets done
  • Staff focuses on po[ulation/patient care
  • Mgr focus on empowering staff
68
Q

Councilor model of shared governance

A

Manages governance through the use of committees or councils

69
Q

Excellant Organizational culture

A
  • Clinically competent peers
  • Collaborative nurse-physican relationships
  • clinical autonomy
  • Support for education
  • Perception of adequate staffing
  • Nurse mgr support
  • control of nursing practice
  • pt-centered values
70
Q

3 Major trends influencing a learning culture & climate

A
  • Patient safety focus in which learning & accountability are guideposts for error control
  • Evidence-based research emphasis on translating findings into practie
  • Explosion of information technology in health care delivery that increases access & transparency of care
71
Q

Patient Safety Culture & Climate

A
  • IOM report: To Err is Human: Building a Safer Health System
  • Safety culture & climate
  • Punitive versus learning culture
72
Q

IOM- Crossing the Quality Chasm (2001)

A
  • Patient-centered care
  • Interdisciplinary teams
  • Evidence-based practice
73
Q

Leadership in culture change

A
  • Committed leadership
  • Planned time for change to take place
  • Authority & responsibility for professional practice invested at the point of service
  • Individual accountabilities & expectations clearly delineated in role descripton
  • Immediate & continual feedback

Leadership (1 decks)

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