Professional Practice Models, Organizational Structure and Models of Care Flashcards
Organizational Charts
visual display of the organization’s positions and the intentional relationships among them, only formal structures appear on this chart, can be tall or flat
Solid lines
Line positions, flow of authority
Dotted lines
staff positions or advisory bodies, consultative relationships
Span of control
number of employees reporting directly to a management position
Scalar principle
number of management layers in the hierarchy
Magnet hospitals
have recognized the benefits of decentralized decision making
Nurses on Boards Coalition (NOBC)
represents national nursing and other organizations working to build healthier communities in America by increasing nurses’ presence on corporate, health-related, and other boards, panels and commissions
Tall Organization advantages
Increased access to managers, greater supervisory capacity, layers of accountability, responsibility and skill
Tall organization disadvantages
potential for micromanagement, slow decision making, less innovation
Flat organization advantages
streamlining of goals, problem solving and resource use; greater staff autonomy, greater innovation
Flat organization disadvantages
decreased access to managers and resources, overextension of managers, communication delays
Attention to people, processes and outcomes
competence and leadership, use of merit based rewards, effectiveness of reporting relationships, information sharing
Work Empowerment structures provide
opportunity for learning, information, support and resources; formal and informal power, proportion, low turnover, low burnout and high job satisfaction
Professional Practice Model
conceptual framework or philosophy of nursing within an organization
Nurse PPM
Represents importance and valuing of nurses in an organization
Support nurse control over practice
Enhance job satisfaction and retention
Must be supported by management/leadership to work
Work best when they parallel organization’s mission, vision, values, philosophy
Mission Statements
Focus on patient care delivery
Inform public of organization’s key goals
Acts as a guide for developing objectives and actions
Vision Statements
Focus on future direction of organization
Meant to be inspirational
Values Statements
Reflect beliefs that guide organizational decision making
Drive how people act in organizations
Philosophy
Explanation of beliefs that determine how the mission and vision will be achieved
Is abstract and describes an ideal state
Policies
Formal guidelines
Help solve recurring problems
Direct decision making
Procedures
Step-by-step directions of how to carry out activity
Evidence based
Includes necessary steps and supplies
Structured Care methodologies
Critical pathways
Evidence-based algorithms
Protocols
Standards of care
Order sets
Clinical practice guidelines
Healthy Work Environments
Found in Magnet organizations
Specific structures/processes that support nurses
High proportion of baccalaureate nurses
Adequate staffing
Collegial interprofessional relationships
Effective nursing leadership
Care delivery model
Operational mechanism by which care is actually provided to patients
Nursing care delivery models
Private duty
Functional
Team
Primary
Case management
Functional Care Model
division of labor according to tasks; “assembly line” approach; fragmentation is a disadvantage
Team Care Model
provision of care to a group of patients by RNs, LPNs, and aides; blurring of scope or practice is a disadvantage
Primary Care Model
primary RN has 24* accountability for plan of care and collaborate with associate RNs; expense is a disadvantage
Case Management Care Model
focuses on an entire episode of illness across care settings
Private Duty Care Model
one to one care; often takes place in the home.
Community Case Management Care Model
process and model to manage care (care coordination organized to achieve specific patient outcomes within the context of fiscal and other resource constraints).
Pt and family centered care
Patient preferences
Realistic care options
Care decisions based on patient values
Improves patient satisfaction
Future Models of Care
Transitional care model (TCM)
Patient-centered medical home (PCMH)
Future models focus on prevention
Emphasis on shared governance
increase in staff participation and autonomy
Current Issues and Trends
Inter-professional collaborative leadership
Whole system integration and shared governance to include patients and the community
