Leadership and Management in Nursing in a Changing Health Care System

NUR 444

Fall 2006

University of Detroit Mercy McAuley School of Nursing

Course # Course Title

NUR 444 Leadership and Management in Nursing in a Changing Health Care System 2 Semester Credits (28 hours) Maggie Carriker, MSN, RN (H) 616-455-3450 (C) 616-240-5360 e-mail: carrikermd@gtlakes.com

Credits Faculty

Course Description Focuses on leadership and management knowledge and skills needed by entry-level practitioners in a changing, integrated health care system. Ethically driven leadership is emphasized with attention to social justice issues within health care systems. Organizational leadership/management theories Strategic Planning Change Managed Care Case Management Quality Management Fiscal Management (resource allocation, budgeting) Human Relations skills Negotiation Conflict Resolution Team Building Labor Relations Coaching and Empowerment NUR 360, 362, 364, 365 NUR 420, 442, 445

Prerequisites Co-requisites Course Objectives

1. Integrate theory and knowledge from leadership, management and nursing literature to develop a foundation for nursing practice and decision making. 2. Use critical thinking leadership skills in simulated learning experiences aimed at implementation of standards of care for individuals, families and communities. 3. Practice leadership behaviors incorporating legal/ethical principles and sociopolitical responsibilities in simulated learning environments. 4. Demonstrate understanding of strategic planning, community partnership development within the complexity of a changing managed health care environment. 5. Practice application of fiscal management concepts and resource allocation in simulated learning situations.
2

6. Exercise relationship-centered skill development specific to leadership and management: collaboration, coaching, and conflict resolution in simulated situations. 7. Discuss research-based knowledge from leadership, management and nursing as the basis of nursing practice. 8. Examine health care delivery systems and policies and their effect on patient and population based care.

Methods/Teaching-Learning Strategies Teaching methods will include lecture, group discussion and experiential, problembased learning that will address major content areas in the course: Strategic planning Constant change Managed care Case management Quality management Fiscal management (resource allocation, budgeting) Prioritization Human relations and leadership skills (negotiation, conflict resolution, team building, labor relations, coaching and empowering staff and community partnerships) Evaluation Methods Exam 1 Exam 2 Exam 3 Final Cumulative Facilitated Discussion Persuasive Position Paper Portfolio Total: Evaluation Criteria Exams (60 points) Exam #1 and #2 are each worth 20 points and will cover specific chapters of the text: Exam #1: Chapters: 1, 2, 3, 8, 10 Exam #2: Chapters: 7, 12, 13, 14, 17, 18, 20, 21 Exam #3, the Final Exam, will cover specific chapters of the text, in addition to cumulative material from Exam #1 and #2. Exam #3 is worth 25 points Exam #3: Chapters: 4, 5, 6, 9, 11, 19, 23 Points 20 20 25 10 15 10 100

Facilitated Discussion (10 points) Each student will facilitate one Learning Exercise discussion (to be assigned during the first class session). Grading Criteria: Introduction/presentation of topic (4 points) Audience engagement (3 points) Guided discussion (3 points)

Persuasive Position Paper (15 points) Each student will submit a 5-7 page persuasive paper due during the last session of the course. Topic to be submitted to instructor by Week 3 of class (9/11/2006). Grading Criteria: Format and style (1 point) Title page, including topic, course name, student name and date Double spaced 12 point font References Grammar, spelling and punctuation (4 points) All aspects of persuasion included (10 points) Introduction (1) Thesis statement/purpose statement (2) Support for the purpose statement (2) Opposing view (2) Response to opposing view (2) Conclusion (1) Potential topics may include: The role of unlicensed personnel in the work place Shared Governance: Does it really work? Should a BSN prepared nurse be paid more than an ADN prepared nurse? Mandated Nurse:Patient Ratios: do they assure better clinical outcomes and can they be achieved? Ethical Principles: How do they impact my leadership behavior? What is the impact of the nursing shortage on nurse staffing and scheduling? Does achieving professional certification in a specialty area achieve better patient outcomes? Do Hours of Work (i.e. 8 hour vs. 12 hour shifts) impact patient care delivery and patient safety? What is the impact of an electronic medical record (EMR) on patient safety? Achieving a Respectful Work Environment: Is it possible? Does involvement in a Professional Association impact the role of the Registered Nurse? Mandatory Stay: Pros and Cons
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Portfolio (10 points) Contents: Resume Letters of Professional Recommendation (3) Personal Professional Philosophy Statement: Minimum length 2 pages (double spaced). To include short term and long term professional goals. Copy of professional license and certifications (BCLS, ACLS, specialty certifications, etc.) Education Transcripts Diplomas Results of Standardized Exams Certificates of continuing education Honors and Awards Professional committee work Professional Associations Community activities Thank you/appreciation documents Grading Criteria: Presentation Personal Statements Organization

3 points 5 points 2 points

Attendance and Participation Attendance and active participation is mandatory. Students are expected to attend all class sessions and participate in learning activities. Grading Scale Letter Grade A AB+ B BC+ C CD+ D F Points 95-100 91-94 88-90 84-87 81-83 78-80 75-77 72-74 69-71 65-68 64 or less

Required Texts: American Psychological Association. (2001). Publication manual of the American Psychological Association (5th ed.). Washington D.C.: APA Marquis, B.L. & Huston, C.J. (2006). Leadership roles and management functions in nursing: Theory and application. (5th ed.). Philadelphia: Lippincott. Michigan Nurses Association. (1999). Legal and professional requirements of nursing practice. (2nd ed.). Lansing, MI: Author.
http://mail.udmercy.edu/Session/382098-SlmViugAIxm2StDjExn/MessagePart/INBOX/31696-04-B/Delegation%20Handbook.pdf nd

AACN Delegation Handbook, 2 Other readings as assigned.

edition, found at above website.

NUR 444 Week

1

Content Outline Date

8/21

Topics

Reading
Marquis & Huston, Chapter 1

Objectives

Course orientation/overview Distinguishing between leadership and management Theoretical perspectives Relationship to practice

Integrate course objectives and expectations Distinguish between leadership and management Value dynamics of chaos theory within the health care system Examine leadership styles and assess appropriateness of each in select situations Introduce portfolio development Analyze tools/processes related to decision making, problem solving and planning Review and apply ANA standards of care to leadership style Explore decision making at various levels of organization, community and government Examine group vs. individual decision making Determine various factors affecting decision making at different levels

8/28

BLACKBOARD ASSIGNMENT Decision making Planing

Marquis & Huston, Chapters 2,3 MNA pg. 9-15

3 4

9/4 9/11

Labor Day No Class PERSUASIVE POSITION PAPER TOPIC DUE Planned Change Fiscal Planning

Marquis & Huston, Chapters 8, 10

Analyze etiologies of professional and/or organizational change Correlate fiscal realities with nursing processes and outcomes Discuss the role of the nurse in planned change Identify proactive professional nursing actions/strategies that address fiscal policies and challenges Analyze the effect of cost, quality and access to care on health care delivery Describe the process for identifying partners for planned change

Week
5 6

Date
9/18 9/25 Exam #1

Topics

Reading
Marquis & Huston, Chapters 12, 13

Objectives

Organizational Structure

Distinguish between formal and informal organizational structures Analyze the relationship between power and position in organizations Assess advantages and disadvantages of various organizational models Analyze the impact of staffing on the delivery of high quality patient care Develop solutions for staffing scenarios and organization of patient care Analyze job descriptions related to patient care needs Differentiate among the various types of patient care delivery systems Examine the role of the nurse in delegation Analyze appropriate delegation Identify the elements that may act as constraints to delegation Apply the legal regulations which guide delegation Determine what attributes are needed to build relationships Analyze the skills necessary to develop a selfdirected collaborative team Determine what it means to empower members of a team Differentiate between constructive vs. destructive conflict resolution Explore negotiation an manipulation as methods of resolving conflict Analyze various methods of conflict resolution.

10/2

Organizing patient care Staffing and scheduling

Marquis & Huston, Chapters 14, 17

10/9

Working collaboratively with others Motivation, delegation and conflict

Marquis & Huston, Chapters 18, 20, 21

Week
9 10

Date
10/16 10/23

Topics
Fall Break No Class BLACKBOARD ASSIGNMENT Vision & Mission Statements Strategic Planning

Reading

Objectives

Marquis & Huston, Chapter 7

Identify skills needed by nursing leaders to implement strategic planning Identify the value of a clear organizational vision and mission statement Examine the impact of congruence between personal mission statement/vision and the organizational mission statement/vision

11 12

10/30 11/6

Exam #2

Communication, team building and time management

Marquis & Huston, Chapters 9, 19

Analyze communication skills Analyze communication skills within the context of conflict management Distinguish between a group and a team Identify concepts that promote team building Identify the connection between time management and priority setting Identify gaps in patient care/access related to diminished resources Evaluate strategies to reallocate resources to meet the changing needs within the health care system Demonstrate self-awareness regarding the ethical principles that most strongly influence personal decision making Use concepts and principles of culture, cultural diversity and cultural sensitivity in leading and managing situations Identify key characteristics of shared governance, work place advocacy and collective bargaining

13

11/13

Socio-political and ethical conflicts in health care

Marquis & Huston, Chapters 4, 6

Week
14

Date
11/20

Topics

Reading
Marquis & Huston, Chapter 23

Objectives

Quality management and outcomes

Relate quality management principles to the quality management process Identify the steps to continually measure and improve quality of performance Differentiate between quality management and risk management Discuss the effect of managed care on institutional quality and outcomes Discuss the role of the nurse in the steps of the quality improvement process Distinguish between legal and ethical obligations in decision making Correlate the legal authority of nursing practice and the nursing process Select appropriate legal nursing actions in various clinical situations Describe the appropriate methods of ensuring Informed Consent Define legal terms that exist in the Michigan State Nurses Rules & Regulations Analyze the connection between career path development and growth as a professional Value professional develo9pment Compare and contrast different types of professional learning opportunities Evaluate the relevance of a Resume, CV and Cover Letter as entrees to interviews Analyze the economic, social and demographic forces that drive change in health care delivery Determining the implications of nursing in relation to each of the major types of health care delivery modes Analyze the effect of cost, quality and access on health care delivery

15

11/27

Legal standards and management/practice implications

Marquis & Huston, Chapter 5 MNA pages 6-7

16

12/4

PORTFOILIO DUE Career Development and planning Nursing leadership and health policy: The Big Picture

Marquis & Huston, Chapter 11

17

12/11

FINAL EXAM and PERSUASIVE POSITION PAPER DUE

10