Module 7

Question 1

What is a PLANNED change?

Answer 1

A well-thought-out change with implementation strategies

Question 2

UNPLANNED change is…

Answer 2

“Here we go”; It just kind of happens unexpectedly

Question 3

Forces driving change in healthcare are?

Answer 3

• Rising healthcare cost
• Decline in reimbursements
• Growing elderly population
• New quality and safety imperatives
• Workforce shortages
• Emerging technology

Question 4

When you think of Lewin’s Change Theory, how should you remember the 3 steps?

Answer 4

A melting ice cube traveling.

Question 5

1st stage of Lewin’s Change Theory?

Answer 5

UNFREEZING (thawed out):
- gather data
- assess need for change
- employees should be aware
- you want everyone on board & recognize the need for change

Question 6

2nd stage of Lewin’s Change Theory?

Answer 6

Moving: when change actually takes place
- Develop plans
- Set goals
- Implement and evaluate

Question 7

3rd stage of Lewin’s Change Theory?

Answer 7

REFREEZING: new status quo; change integrated &stabilized
- Nurse managers will INSPECT what they EXPECT
- Evaluate the change

Question 8

What part of the nursing process best correlates with the 1st stage of the change theory?

Answer 8

Assessing and Diagnosing

Question 9

Planning and Implementing correlate with what change theory?

Answer 9

2nd stage of the Lewin’s Change Theory = Moving

Question 10

What part of the nursing process does the 3rd stage of the change theory best correlate with?

Answer 10

Evaluation!

Question 11

Tell me about a DRIVING force.

Answer 11

It’s a positive force; things are pushing change forward.

Question 12

What is a Restraining Force?

Answer 12

Obstacle or negative force; it’s things that impede change

Question 13

What is important to know about change?

Answer 13

Communication is IMPORTANT and resistance to change should be expected.

Question 14

What are types of reactions to change?

Answer 14

Active
Passive
Indifference
Fear of Loss
Disruption of Interpersonal Relationships

Question 15

Disruption of interpersonal relationships can be described as?

Answer 15

A change that does not allow you to see your friend during shift change anymore

Question 16

What is the most important stage of the budgeting process?

Answer 16

PLANNING!

Question 17

What are the steps of the budgeting process?

Answer 17

Planning
Coordinating and Communicating
Monitoring Progress
Evaluating Performance

Question 18

What happens in the coordinating and communicating stage?

Answer 18

Various people will come together to discuss resources and resource allocation will be discussed

Question 19

What is VARIANCE?

Answer 19

Difference between planned budget and actual results

Question 20

Favorable variances are?

Answer 20

Better than expected (5000hr budget and only used 4000hrs)

Question 21

Unfavorable variance would be?

Answer 21

Worse than expected (Brought in agency RNs and now $5000 over budget)

Question 22

What is variance analysis?

Answer 22

process that looks at budget to see if you had favorable or unfavorable variances; are within in budget or not

Question 23

What budget includes salaries, overtime, benefits, education, and staff development/training?

Answer 23

LABOR budget

Question 24

What budget is the LABOR budget a part of?

Answer 24

Operational; it’s the largest part of it.

Question 25

What is the operational budget?

Answer 25

Financial plan for organization; lists the plans, revenues, expenses, in designated time period of the year

Question 26

What is the CAPITAL budget?

Answer 26

funds for major equipment or construction projects (HIGH dollar stuff)

Question 27

Tell me about the INCREMENTAL budgeting method.

Answer 27

Looks at historical data
like How well you did in the past?
Simplest way to budget

Question 28

Tell me about the ZERO-BASED budgeting method.

Answer 28

Complicated budget that’s redone from scratch every year.
** Hospitals do NOT use this budget!

Question 29

What is “unit of service” cost?

Answer 29

Basic measure of product/services provided

Question 30

Patient-days is measured by?

Answer 30

Nursing units

Question 31

Procedures is measured by?

Answer 31

Cath labs and thinks similar to that

Question 32

Minutes are measured by?

Answer 32

Operating room
Occupational Therapy
Physical Therapy
Speech-Language Therapy

Question 33

Direst cost is directly associated with?

Answer 33

Units of service
Ex. Nursing care, admission kits

Question 34

Indirect cost is related to?

Answer 34

Operating expenses but not services
Ex. Housekeeping, Utilities

Question 35

What kind of cost describes hours are never flexed because they work regardless of consensus?

Answer 35

FIXED cost.
Ex. Administrative and Leadership positions

Question 36

What cost changes based on changes in the unit of service?

Answer 36

VARIABLE cost.
Ex. Pts in the ICU vs Pts on med-surg floor
or IV supplies will vary b/c of consensus

Question 37

What are the 3 main SOURCES of payment for healthcare?

Answer 37

Government insurance (Medicare/Medicaid)
Private insurance (Ambetter, Humana)
Out-of-pocket

Question 38

THREE Ways healthcare is paid for?

Answer 38

• Fee for service
• Value-Based Purchasing
• Prospective Payment System

Question 39

What is VALUE-BASED purchasing?

Answer 39

Pay for performance

Question 40

What are the 4 COMPONENTS of value-based purchasing?

Answer 40

Safety
Efficiency&Cost Reduction
Clinical Outcomes
Person&Community Engagement (HCAHPS)

Question 41

What does value-based purchasing want you to implement?

Answer 41

Evidence-based practice!

Question 42

T/F: There is an incentive if hospitals do well (bonus) and they are penalized if they do poorly.

Answer 42

True!!