[Ebook PDF] Nurse Executive Review and Resource Manual, 3rd Edition

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Nurse Executive Review and Resource Manual, 3rd Edition

ISBN-13: 978-1935213789
ISBN-10: 1935213784

Author: Al Rundio (Author), Virginia Wilson (Author), Faye A. Meloy (Author)

Are you looking into how to advance your professional development through certification? Need a reliable and credible reference resource? No matter where you are in the process, make sure you have the most valuable review and resource tool at your disposal. The Nursing Knowledge Center’s Nurse Executive Review and Resource Manual is a must-have tool for nurses planning to take the American Nurses Credentialing Center’s (ANCC’s) Nurse Executive certification exam. Based on the official ANCC certification exam test content outline, this review and resource manual will help you: • Study and analyze comprehensive material and concepts written by nursing experts. • Develop a recommended seven-step plan to equip you for the exam and map out what to do on the day of the exam. • Prepare for and familiarize yourself with nurse executive standards of practice. • And much more … Make the Nurse Executive Review and Resource Manual a key resource in your certification preparation.

HEALTHCARE ENVIRONMENT
High-quality healthcare organizations are driven by attention to their customers, excellent workmanship, empowered workforces, and innovation and change as a response to their environment. The Patient Protection and Affordable Care Act of 2010 established the mandate of increasing access to care while decreasing costs. Ongoing healthcare reform emphasizes the importance of collaborative teams in the redesign of healthcare delivery systems that provide high-quality, client-centered, mutually accountable care across the lifespan (Roussel, Thomas, & Harris, 2016). Consequently, healthcare providers are
challenged to focus on quality, cost-effectiveness, and responsiveness to the voice of the consumer in all aspects of care.
The overall goal of transforming the healthcare system is to develop a seamless, coordinated care approach for clients by: 1) improving population health and client outcomes, 2) enhancing the client experience, and 3) continued improvements in providing high-quality services at a lower cost (Stiefel & Nolan, 2012). Traditional measures of these outcomes are now being combined into value-based competitive reimbursement models from third-party payors and regulatory agencies. It is generally accepted that in order to survive financially and competitively, healthcare organizations must break down traditional organizational hierarchies and embrace a culture of collaboration and teamwork among providers and stakeholders (including consumers) at all levels. High-quality healthcare organizations
recognize the environmental factors inherent in maintaining competitive advantage and ensuring financial viability include an examination of organizational culture with an emphasis on team-building, group dynamics, conflict resolution, negotiation, reframing historical sources of power, environmental issues, cultural competence, and diversity.
ORGANIZATIONAL CULTURE AND ENVIRONMENT
It is impossible to promote high-performing teams without true commitment to teamwork at all levels. Shared vision, open dialogue, trust, and a sense of belonging are critical elements for overcoming organizational challenges and ongoing strategic development. Consequently, it is important to insure that the culture, alignment of corporate objectives, and educational/technical supports are congruent with establishing a culture of teamwork and collaboration. Longstanding paradigms of organizational hierarchies, privileged conversations, and discipline-specific silos must be replaced by an organizational climate
that fosters equalization of power, shared governance, participative management, transparency, open communication, and individual/group contributions to organizational goals. Synergy of vision and desired outcome is essential. Team-related activities and organizational objectives must also be aligned. Stakeholders must understand how their contributions align with corporate objectives and feel that their efforts are valued. It is increasingly recognized that alignment of the culture and capabilities of an organization are derived from philosophies and practices related to the strategic management of human capital (including the free flow of information, job security, selective hiring practices, elimination of status differences between groups, decentralization of authority, and teambuilding) as basic elements of organizational design (Pfeffer & Veiga, 1999).
TEAMBUILDING
“A team remains the most flexible and most powerful unit of performance, learning, and change in any organization” (Katzenbach & Smith, 2003, p. XIX). The abilities to express one’s ideas clearly and decisively, to listen attentively and respectfully, and to invite a range of opinions are among the communication skills that help managers build team cohesiveness. Teams usually are developed reflecting the diversity and culture of the organization, and although the chief executive may be fundamental in the formation of high-performance teams, he or she is not always a team leader.
According to Katzenbach and Smith (2003), developing a team is the inclusion of “a small number of people with complementary skills who are committed to a common purpose, performance goals, and approach for which they hold themselves mutually accountable” (p.275). A team develops around the task to be accomplished while taking into account the mix of personalities and competencies; the desired performance outcomes; and the processes of communication, involvement, performance orientation, and enabling leadership (Higgs, 2006).
Central to a team’s success will be its members’ work behaviors such as constructive listening and giving the benefit of the doubt to others (Katzenbach & Smith, 2003). Team members need to not only be mature and self-motivated, but also be aware of their social and cultural differences, appreciate each other’s cultural diversity, and have a basic understanding for each other’s value systems. Only through an active display of this understanding and open and nonjudgmental communication can a team develop its highest potential to meet group goals and complete its mission.
The team leader can facilitate this process by using good meeting skills and appropriate meeting behaviors. The task of reminding team members of their mission, goal, and tasks falls to the leader as well.
GROUP DYNAMICS
Teams tend to evolve through a predictable development process that was first described by Tuckman in 1965 and then modified by Tuckman and Jensen in 1977 (Smith, 2005). The five stages include: Forming, Norming, Storming, Performing and Adjourning. In the Forming stage individuals come together and begin to establish team relationships. While there is often a sense of enthusiasm for the task at hand, individuals tend to be cautious in their communication with one another; as they may be relative strangers and may need purposeful teambuilding activities. A skilled team leader or facilitator may be needed to clarify team purpose, goals, and to assist the team in establishing rules of engagement.
As the group proceeds through the maturation process, it arrives at the second stage, known as Storming. In this stage, members of the group compete for position, power, and status; informal leaders may emerge. When team members come from differing backgrounds there is a tendency to approach critical issues from differing standpoints and opinions that cause uneasiness and conflict among group members. These differences need to be openly confronted and addressed proactively so that effective resolution can be achieved occur in a timely fashion (Kelly, 2008). The storming phase of group work is critical to team success.
Katzenbach and Smith (2003) assert that real teams don’t emerge unless individuals take risks, address conflict, and develop a sense of trust and interdependence. The third stage of group formation, Norming, is where the rules for working collaboratively are made explicit; structure, roles, and relationships are further clarified resulting in a sense of cohesion. Team members become more adept at resolving conflict, respect differences in opinion and work cooperatively to achieve team goals. The leader’s role during this stage of group development focuses on relationship building and assisting the group in overcoming
barriers.
As the group matures, it enters the Performing stage. In this phase, group cohesion, collaboration, and solidarity are evident. Personal biases are overshadowed in an effort to achieve team goals (Kelly, 2008). The leader’s role is to provide feedback on the work that the group is accomplishing, redirect group energy when necessary, and further cultivate interpersonal relationships.
The final stage of team development, Adjourning, addresses the individual and group tasks associated with completion of the team’s specific charge and dissolution of the formal team structure. During this phase of termination and consolidation, the ream reviews their activities and evaluates the outcome of their efforts (Kelly, 2008). The development of strong interpersonal relationships inherent in team-building and the loss of team structure may be difficult for some team members. Consequently, a focus on closure is paramount. At this stage it is appropriate to recognize team accomplishments and to facilitate an
ongoing culture of collaboration and teamwork (Roussel, Thomas, & Harris, 2016). Celebration of both successes and failures are essential for building a culture of inclusion and cooperation by: valuing the process and the contributions of individuals involved, supporting an ongoing, proactive culture of change, celebrating insights gained and providing a sense of renewal that will serve as the cornerstone for ongoing collaboration and teamwork necessary to meet the inherent challenges of redesigning healthcare delivery now and in the future.
Team development and function rarely proceed in a completely linear fashion. Changing circumstances and intervening variables may have a profound impact on team function, alignment, and outcomes. Consequently, management intervention may be needed when teams regress or encounter seemingly insurmountable barriers to performance. In these instances the leader should consider strategies to assist teams in overcoming obstacles, evaluate whether modifications to team membership are needed, and in extreme cases, determine whether planned abandonment of the team activity is needed. Experts have also suggested that the group formation process, and thus the productivity of the group, can be accelerated under the guidance of a skillful facilitator or in the face of actual or fabricated crisis (McKnight, Kaney, & Brewer, 2010).