Effective Leadership and Management in Nursing, 8th Edition

H A .p rv p C - 3 - 3 Click to edit Master text styles Second level Third level Fourth level Fifth level Click to edit Master title style Effective Leadership and Management in Nursing, Eighth Edition Eleanor J. Sullivan Effective Leadership and Management in Nursing CHAPTER EIGHTH EDITION Click to edit Master text styles Second level Third level Fourth level Fifth level Click to edit Master title style Effective Leadership and Management in Nursing, Eighth Edition Eleanor J. Sullivan Click to edit Master text styles Second level Third level Fourth level Fifth level Click to edit Master title style Click to edit Master text styles Second level Third level Fourth level Fifth level Designing Organizations Learning Outcomes Discuss how organizational theories differ. Describe the different types of health care organizations. Explain how health care organizations are structured. Discuss various ways that health care is provided. Learning Outcomes Demonstrate how strategic planning guides the organization s future. Discuss how the organizational environment and culture affect workplace conditions. Organizational Theories Were unexplored until the Industrial Revolution Include the following theories Classical Contingency Humanistic Organizational Theories Include the following theories Chaos Systems Complexity Classical Theory Built around four elements Division and specialization of labor Chain of command Organizational structure Span of control Figure 2-1 Chain of authority. Humanistic Theory Focuses on social aspects of organizational design Views social relationships, group pressure, and search for personal fulfillment as motivators Says formal authority only works with willing participants Systems Theory A system is interrelated parts arranged in a unified whole. Systems can be open or closed. Organization is a recurrent cycle of input-throughput-output. The manager is the catalyst for the process. Contingency Theory Chaos Theory Organizations are living, self-organizing systems that are complex and self-adaptive. Creativity and flexibility are necessary to adapt to change. The leader s role is to build resilience, maintain balance, and encourage creativity. Complexity Theory Random events interfere with expectations. No linear cause and effect to explain outcomes. The system interacts and adapts to change. Managers must encourage the flow of information in all directions, not just top to bottom. Hospitals Long-Term Care Facilities Provide professional nursing care and rehabilitative services May be freestanding or part of hospital Limit length of stay May be residential care facilities (nursing homes) where care is supervised by RNs and LPNs Home Health Agencies Provide intermittent, temporary health care in the home by skilled or unskilled providers May offer services other than nursing such as physical therapy or medical equipment May offer hospice care Temporary Service Agencies Provide nurses and other health care workers to hospitals Provide private duty nurses to patients in the hospital or at home Health Care Networks Deliver a continuum of care Provide geographic coverage for buyers of health care services Accept risk in taking a fixed payment for providing health care for all persons in selected group Interorganizational Relationships Horizontal integration Organizations in a network provide the same or similar services e.g., all hospitals provide comparable services Figure 2-6 Horizontal integration. Interorganizational Relationships Vertical integration Dissimilar but related organizations in a network provide a continuum of services Figure 2-7 Vertical integration. Interorganizational Relationships Corporate health care network Figure 2-8 Corporate health care network. Managed Health Care Organizations Deliver services through a formal arrangement with a group of individuals Include HMOs, PPOs, and POS plans Accountable Care Organizations Contract with Medicare to provide care to a group of Medicare recipients More flexible than HMOs because consumers can choose providers outside the network Traditional Organizational Structures Functional Employees grouped in departments by specialty Hybrid Contains both self-contained and functional units Traditional Organizational Structures Figure 2-3 Service line structure. Different Types of Health Care Organizations Private or government Voluntary (not for profit) Investor owned (for profit) Sectarian or nonsectarian Redesign Patient-centered care model E.g., medical home Focus on specific service lines Lean thinking Flat, decentralized organizational structure Strategic Planning Philosophy Vision statement Mission Goals Organizational Environment System-wide conditions that contribute to a positive or negative work setting Positive environment has a positive effect on patient outcomes Nurse manager plays a key role in maintaining a positive environment Healthy Work Environment Skilled communication True collaboration Effective decision making Appropriate staffing Meaningful recognition Authentic leadership Organizational Culture Encompasses basic assumptions and values held by members of the organization Organizational Culture Varies among institutions, subcultures, and countercultures Consonance occurs when the subculture s norms and traditions agree with the organization s Dissonance occurs when they are not in agreement