Module 3 Discussion: Today’s Health Care System

Module 3 Discussion: Today’s Health Care System

: Video Presentation: Creating the Best Healthcare System
According to Donald Berwick, a nationally known healthcare quality expert and multiple other national leaders, healthcare in the US has an unprecedented opportunity to improve. Questions are continually raised about how can we change a system as large, as complex, and as entrenched as today’s healthcare system. Creating “the best healthcare system possible” is the major challenge our nation is facing at this time. Module 3 Discussion: Today’s Health Care System
1. Prepare a 3-5 minute informative video presentation answering the following questions below
a. If you could make one change in today’s healthcare system, what would it be and why? How would you know the change improved the system? What are the legal and ethical implications of this change?
b. As a BSN degree nurse, you have been asked to talk with the nursing leaders of the organization about your predictions related to changes in nursing and healthcare in the future. Include the following topics in your conversation.
1. The changing nursing role in quality, patient outcomes, and reimbursement
2. Type of nursing care delivery model you believe will need to be in place by 2020
3. What types of restructuring activities your organization will need to be involved in over the next several years to be ready for 2020.
4. Criteria for use to evaluate effectiveness of a nursing care in the organization

2. This short video is equivalent to doing a presentation in class. Make sure you know your information; it is presented accurately and with confidence (make “eye contact”, make sure you speak clearly, reference any material you used).
3. Post your video to Canvas under the Discussion tab for Week 3.
4. Post your citations in APA in the same posting as the link.
5. Answer any questions regarding clarification that are posed to you by either classmates or your instructor in the Canvas discussion thread
6. Review classmates’ videos. Post a question on at least 2 other presentations

Module 3 Assignment:Design of Care and Management of Resources

• Due May 1 by 11:59pm
• Points 10
• Submitting a file upload

1. (Points 2) Over the past few years, many state and local governments have been debating the implications of labor unions (collective bargaining). The states have huge budget shortfalls and believe worker and union demands for increasing salaries, health care benefits, and retirement benefits have created much of the budget problems. On the other hand, the unionized workers believe the unions have protected these owed and justified benefits and their jobs, and therefore do not want to lose the bargaining power of union representation. This media attention has piqued the attention and interest of the nursing staff in your organization. Module 3 Discussion: Today’s Health Care System
Your organization has no employee unions; however, the staff nurses in three units have been heard discussing recent telephone calls and emails from the SEIU (Service Employee International Union) encouraging them to consider unionizing. Assume that you are a staff RN. What would be the benefits of collective bargaining for staff nurses in the organization?
Assume that you are a manager/director/ or other member of the administration team. Discuss the labor law regarding what managers, directors, and any member of the administration can say and do and the restrictions all members of management must adhere to and what rights and restrictions apply to the employees.

Module 3 Discussion: Today’s Health Care System
What is a “right to work state”? Is Kentucky a right to work state?

Refer to Sullivan Chapter 25 and at least one other reference as you write the answers above. Document all references used.

2. (Points 2) You have just been promoted to the role of Chief Retention Officer in a 100 bed inpatient rehabilitation center. The average length of employment for all staff is two years. Nursing turnover is 50% within the first 18 months. Due to the cost of recruiting new staff and the negative effect of turnover on patient outcomes, the Board of Directors has demanded the CEO and CNO reduce turnover of all employee groups–Hence the creation of a Chief Retention Officer position. The CNO has directed you to establish a “healthy working environment” that will reduce turnover. Write a one/half page paper on what constitutes a healthy work environment. Provide two references in your answer.

3. Part One and Two of this question relates to organizational structure.

Part One (.6 points or .2 each)

Read the following scenarios and list the type of organizational structure (functional, service-line, hybrid, matrix, parallel, etc—Sullivan, Chapter 2 and Finkelman, Chapter 4) that most likely exists.

a. Ms. Apple is the Oncology Product Line Manager. She reports to the Vice
President of Patient Care Services (functional structure) and the Vice President of Product Line Management. Provide an answer other than hybrid organization.

Organizational structure (Best answer per text defintion)? ________________

b. Nurse Manager Orange reports to the Director of Nursing who reports to the Vice
President of Patient Care Services. The Vice President of Patient Care Services
reports to the CEO. Decision making is centralized within the organization.

Organizational structure (Best answer per text definition)? _________________

c. The Dir of Nursing reports directly to the CNO who is responsible for the nursing department; the CNO reports to the CEO who reports to the board.
The MD Chief of each Service Line reports to the Chief Medical Officer (CMO); The CMO reports to the board.

Organizational structure (Best answer per text definition)? _________________

Part Two (Points 2.2, divided as below) Module 3 Discussion: Today’s Health Care System

Answer the below questions. Specific answers are required based on the text
definition.

a. (Points 1) List and define/explain the five key principles of classical theory, as noted in the Finkelman text.
1.
2.
3.
4.
5.

b. (Points .2) An organization that covers the continuum of care can be described as a ___________ integrated organization. This type of organization might include a hospital, a rehabilitation facility, a nursing home, a home health agency, and an ambulatory care center.

c. (Points .2) A ________________________ organizational structure spreads tasks and authority over various components/departments within the organization.

d. (Points .2) Chain of command represents which type of authority, staff authority or line authority? __________________________________

e. (Points .6) Finkelman describes three levels of health care services within the health care delivery structure; the service provided by each level varies based on the complexity of care required. List and define the three levels.
1.
2.
3.

4. (Points 1 or .2 each) Read the following scenarios and list the “model of nursing care delivery” or “integrated model of care” that most likely exists for this situation. Reference: Sullivan, Chapter 3.

a. Nurse Smith, LPN, administers medications for all patients on the unit. Nurse
Jones, RN, is responsible for the IV therapy for all patients on the unit. Nursing
Assistant Thomas does vital signs and baths for all patients.

Model? ______________________

b. Charge RN Candy will be working with another RN, an LPN, and a
assistant to care for 16 patients on the upcoming 7p-7a shift.

Model? ___________________________

c. Assignments are made as follows: RN1 has patients in rooms 200-206; RN2 has patients in rooms 207 to 211, etc. The RN’s are responsible for doing all
care for their assigned patients.

Model? ___________________________

d. Jones is responsible for planning and coordinating the “24-hour” care for a
patient load of eight patients, for the duration of the patient’s hospital stay.

Model? _________________________

e. Nurse Smith carries an assignment of 28 patients and is responsible
to identify, coordinate, and monitor the implementation of services needed to
ensure a smooth transition to the next level of care (home, nursing home, etc) after the patient is discharged from the hospital. Nurse Smith does not do bedside care, but does coordinate the interdisciplinary rounds that occur on the unit each week. Today Nurse Smith spent several hours talking to insurance companies to obtain approval for patients to remain in the hospital for additional days.

Model? _____________________________

5. (Points 1.2, divided as below) Answer questions a-d below that relate in some way to quality of care.

a. (Points .4) What is the difference between total quality management and continuous quality improvement?

b. (Points .4) Share an example from your work setting when TQM could be used to improve care outcomes? Also share an example from your work setting when CQI could be used to improve care outcomes?

c. (Points .2) Describe a situation when Lean Six Sigma would be an effective quality management strategy to implement.

d. (.2 Points) ____________________ , or applying the best scientific evidence, helps to identify and assess high quality, clinically relevant research that can be applied to clinical practice.

6. (Points 1) Fernadez et al. (required journal article) presented information about models of care in nursing. They describe results of their study in relation to how models effect patient outcomes, nursing outcomes and organizational outcomes.

a. List 5 patient outcomes that can be impacted by the model of care used. Answers must match content from the article.

b. List 5 nursing outcomes that can be impacted by the model of care used. Answers must match content from the article.

c. List one organization outcome that can be impacted by the model of care used. Answer must match content from the article.

Module 3 Discussion: Today’s Health Care System