nursing roles within an organization Flashcards
management
- act or manner of guiding or taking charge of handling, direction, or control
- process of leading and directing all or part of an organization through the deployment and manipulation of resources
characteristics of a manager
- assigned position
- legitimate source of power
- specific responsibilities
- emphasize control
- manipulate people, environment, money, time, and other resources
- greater formal responsibility and accountability
- direct willing and unwilling subordinates
management functions/process
- planning activities
- organizing
- staffing
- directing
- controlling
leader
- individual who is out front, taking risks, attempting to achieved shared goals, and inspiring other to action
- person who influences and guides direction, opinion, and course of action
- only a person’s behavior determines if he or she holds a leadership role
characteristics of leader
- no delegated authority
- obtains power thru influence
- wider variety of roles
- may be part of the formal organization
- emphasize interpersonal relationships
- direct willing followers
- goals may or may not reflect those of the organization
the great man theory
- some people are born to led
- others are born to be led
trait theory
certain characteristics or personality traits make them better leaders
behavioral theories
- authoritarian/autocratic
- democratic
- laissez-faire
authoritarian/autocratic
- usually found in very large bureaucracies
- no autonomy, decision making, communication, no motivation (coercion),
- status: “I”
- punity criticism
- direction with commands
democratic
- decision making involves others
- good autonomy, communication
- a part in decision making
- less control
- “we”
- productivity not as good
- time wasted on decision making
- constructive criticism
- motivation with rewards
- promotes autonomy and growth in individual workers
laissez-faire
- permissive, with little or no control
- all autonomy
- group decision making
- no control, productivity, criticism, motivation, or direction
- “you”
- communication among group, not towards leader
- group apathy and disinterest can occur
- appropriate when problems are poorly defined and brainstorming is needed to generate an alternate solution
situational & contingency theories
- leadership styles should vary according to the situation or the individuals involved
- the situations should determine the directives given after allowing everyone to know the problem
- no one leadership style is ideal for every situation
interactional theories
- leadership behavior is generally determined by the relationship between the leader’s personality and specific situation
- leader and follower contributing to the working relationship and both receiving something from it
- leader-follower-situation
theory z
- consensus decision making
- strong bonds of responsibility
- lifetime employment and slower promotions
- holistic concerns for workers
transformational leadership
- both leaders & followers have the ability to raise each other to higher levels of motivation and morality
- the manager is committed, has a vision, and is able to empower others with this vision
- leads followers to levels of higher morals
transformational leader
- identifies common values
- is committed
- inspires other with vision
- has long-term vision
- looks at effects
- empowers others
transactional leader
- focuses on mgmt task
- is a caretaker
- uses trade-offs to meet goals
- does not identify shared values
- examines causes
- uses contingency reward
full-range leadership theory
- inspirational motivation
- idealized influence (attributed or behavior)
- intellectual stimulation
- individualized consideration
- contingent reward
- active mgmt by exception
- mgmt by exception passive
- non leadership
* *need a combo of this
integrating leadership and mgmt skills
- think in longer term
- look outward, toward the organization
- influence others beyond their own group
- emphasize vision, values, and motivation
- politically astute
- think in terms of change and renewal
organizational structure
refers to the way in which a group is formed, its lines of communication, and its means for channeling authority and making decisions
formal organizational structure
provides a framework for defining managerial authority, responsibility, and accountability
informal organizational structure
is generally a naturally forming social network of employees
bureaucracy
- organizational theory
- clear division of labor
- well defined hierarchy of authority
- impersonality of interpersonal relationships
- system of procedures
- system of rules
- employment and promotion
components of an organization structure
- relationships and chain of command
- span of control
- managerial levels
- centrality
span of control
- the # of people directly reporting to any one manager
- the # of interactions expected of the manager
- ranges from 3-50 employees
top-level managers
- look at the organization as a whole
- coordinating internal and external influences
- ex: CEO, CFO, DON
middle-level managers
- coordinate the efforts of the lower level of the hierarchy
- the channel between lower and top level managers
- ex: nurse manager
first-level managers
- concerned with their specific unit’s work flow
- ex: charge nurse
centrality
- location of a position on an organization chart where frequent and various types of communication occur
- middle manager has a large degree of centrality
line structures
authority and responsibility are clearly defined
ad hoc design
- facilitate completion of a project
- form a structure to finish a project
matrix structure
focus on product (pt outcome) and function
service line organization
address the shortcomings
flat designs
- remove hierarchical layers
- saves money
- better communication
limitations of organization charts
- informal structure
- authority
- responsibility
- accountability
centralized decision making
managers at the top of the hierarchy make decisions
decentralized decision making
diffuses decision making throughout the organization
stakeholders
have interests in what the organization does but may or may not have the power to influence the organization to protect their interest
organizational culture
- the total of an organization’s values, language, traditions, customs, and sacred cows
- a system of symbols and interactions unique to each organization
organizational climate
how employees perceived an organization is
philosophy
describes the beliefs values, assumptions, and goals of the institution
policies
general descriptions of the agency approach to achieve the agency’s goals in an expedient manner
procedures
describe a specific process needed to complete at task
quality control
activities that are used to evaluate, monitor, or regulate series rendered to consumers
hallmarks of effective QC programs
- support from top-level administration
- commitment by the organization
- goals reflect search for excellence
- ongoing process
basic steps of QC
- determine criteria first
- info is collected to determine if the standard has been met
- educational or corrective action is taken if the criterion has not been met
benchmarking
process of measuring practices against the best performing organization
steps of auditing QA
- establish control criteria
- ID the info relevant
- determine ways to collect info
- collect and analyze info
- compare collected info
- make a judgment about quality
- provide info, take corrective action
- reevaluate
standard
- predetermined level of excellence that serves as a guide for practice
- used as a measurement tool, must be objective, measurable, and achievable
audit
systematic and official examination of a record, process, structure, environment, or an account to evaluate performance
retrospective audits
after a pt is d/c, looking back on pt chart
concurrent audits
while the pt is in the hospital
prospective audit
future
outcome audits
determine what results occur as a result of specific nursing interventions
process audits
measure how nursing care is provided
structure audits
assume that a relationship exists between quality care and appropriate structure
total quality management/continuous improvement
- individual is the focal element on which production and service depend
- empowerment of employees
- quality is more important than profit
the toyota production system
- eliminate problems at their root
- decentralized problem solving
risk mgmt
- attempts to analyze problems and minimize losses after a pt care error occurs
- directed towards IDing, evaluating, and taking corrective action against potential risk that could lead to injury of a pt, staff, or visitor
functions of risk mgmt
- define situations that place they system at financial risk
- determine frequency of occurrences
- intervene and investigate identified events
- identify potential risk or opportunities to improve care
strategies to minimize medical errors
- reporting and analyzing errors
- the leapfrog group
- a six stigma approach
- reforming the medical liability system
