Organizational Delivery Flashcards

Question

Matrix

Answer 1

may combine a tall and flat. There are often two directions for authority, accountability and communication i.e. financial services, quality assurance, etc not clear lines of communication, more opportunity for everybody to engage and everybody to be involved in decisions, interconnected clusters that tend to move decision making up and down, allows people to break free of limits of a beurocratic design Advantages: increased flexibility, autonomy of, get assistance and expertise from experts, get a lot of creativity, can offers creative solutions to problems, teams supervise and manage themselves

Answer 2

turf wars, not one clear boss, can get people who have a great need for control who don’t like teams, personality conflict, can be time consuming some may not feel the need to push forward, can be hard to control because no clear lines of leadership

Answer 3

Org. designs are classified by their characteristics of complexity, formalization and centralization How the labor is organized will have a direct bearing on how the mission of the organization is achieved. Must consider the complexity of an organization and the division of labor.(May be geographic area such as O.R. or Amb Care or Program i.e. cardiology or oncology) There must be a clear division of labor (work undertaken by individuals or groups for specific groups of people). A system of procedures to deal with work situations must exist– i.e. what must be accomplished in a day or shift.

Answer 4

Scalar Process the vertical growth ( the more steps there are the more centralized the decision making is.) Functionalization horizontal growth (different kinds of duties at the same level)

Answer 5

– refers to # of people a manager is supervising. Narrow/short – few people/tasks 3-5 subordinates. Allows for more control (tall structure) Broad/wide – many people and tasks, decreased control (flat structure.

Answer 6

Line function – hierarchy of personnel that is from executive to workers at bottom. Involves direct responsibility to meet objectives. Have authority for decision making. Line positions use solid horizontal & vertical lines Staff function – may assist line positions, provide support, advise and counsel (do not confuse with specific jobs such as ‘staff nurse’ etc.). Staff positions are recognized through broken lines Solid vertical lines – line position Solid horizontal lines – line position Broken lines – staff position

Answer 7

1: Total patient care or Case Method * 2: Functional method * 3: Team method * 4: Primary method * 5: Nursing Case Management* 6:Emerging models -not tested on this one (partnership or collaborative methods) five most well known methods of organizing nursing care for pt care delivery

Answer 8

Oldest known model - Nurse: patient ratio 1:1 Is the predominant model of care in high acuity settings. ADVANTAGES consistent, holistic care subtle changes noted quickly Very useful with complex patients

Answer 9

expensive | not ideal with nursing shortage

Answer 10

Each employee has a designated set of tasks, skills and activities ADVANTAGES (Figure 14-3) efficiency unskilled workers can be trained to do specific tasks give care to large numbers of patients (cost effective

Answer 11

fragmentation of care confusion for patients Critical changes may go unnoticed poor communication lines

Answer 12

This model of care is based on the basis that each unit will have 2 or more teams to provide care to a geographic location of patients. Each team has variously educated care providers i.e. RN, LPN, Care Aid etc. ADVANTAGES improved pt. satisfaction cost effective Works with multiple levels of health care ie RN, LPN, HCA

Answer 13

ifteam leader has poor communication/leadership skills Duplication of care Need time for conferencing

Answer 14

One nurse functions as the patient’s primary care giver throughout their entire length of stay. The RN plans and delivers all the care. ADVANTAGES (Figure 14-6) noted increased quality of care. Nurses further their education and knowledge to provide optimal care of their patients. Increased job satisfaction establish relationship with pt and family Decreases # of unlicensed personnel

Answer 15

Lack of experience or education of RN; shorter stays, large # of part time RN’s RN are held accountable even if not physically present for 24 hour responsibility of care Costly

Answer 16

Refers more to a system in which health care services are controlled and monitored. Key to this model is the identification of a critical pathway for care and treatment. RN’s most often act as the case managers. (Figure 14-7) ADVANTAGES Pt receive more services & have fewer unmet needs cost effective Better pt. monitoring, decreased complications Nurse satisfaction

Answer 17

Duplication of services, | Turf wars b/t services i.e. RN and social worker etc

Answer 18

New models today are generally a hybrid of the traditional models. There is a growing trend towards partnership or collaborative practice models. Primary Nursing Hybrid partnership Model and Primary Nursing Hybrid: Patient-Focused Care. The goal is to ensure delivery of the right care by the right provider. Care may be provided by an RN, LPN or UCA. Need to ensure effective and efficient utilization of all health care team members ADVANTAGES Cost effective Using innovative approaches with new technology

Answer 19

Roles of RN and LPN are not clear; LPN must have pt. who is stable with predictable outcomes. Both groups focus on tasks and activities blurring their roles

Answer 20

This model is based on patient characteristics and nurse competencies. Synergy between patient characteristics and nurse competency helps optimize patient care. This model is just beginning to emerge in Canada.