Organizational Structures and Leadership

In most health care settings, it is unlikely that you would hear the terms “ad hoc” or “matrix” as you walk down the hallway. Although it is helpful for any organization to delineate pathways of responsibility and authority in an organizational chart, the lived experience of these structures is most apparent through the inquiries and behaviors people share everyday.

In your own workplace, you may find yourself wondering, who should I turn to when I have a practice dilemma? or Where can I go to learn more about this issue? These questions speak to the intricacies of formal and informal organizational structure and leadership.

To prepare:

• Review the information presented in Chapter 12 of the course text. Focus on the information about formal versus informal structure as well as the types of organizational structures.
• Consider the overall structure or hierarchy of your organization or one with which you are familiar. Which organizational structure best describes your organization—line (or bureaucratic), ad hoc, matrix, service line, or flat? Note: It is possible to have a combination of structures in one organization. Is decision making centralized or decentralized in this organization?
• What is the role of committees, task forces, and councils in the organization, and who is invited to join? Consider how this relates to formal and informal leadership.
• Reflect on how decisions are made within a specific department or unit. Which stakeholders provide input or influence the decision-making process? Assess this in terms of formal and informal leadership.
• To support your analysis, consider your own experiences and investigate these matters by speaking with others at the organization and reviewing available documents. Be sure to consider how the concepts of formal and informal structure and leadership relate to one another and are demonstrated in the organization and in the particular department or unit.

Post on or before Day 3 a (1) depiction of your organization’s formal structure, indicating whether it is best described as line, ad hoc, matrix, service line, flat, or a combination. (2) Describe how decisions are made within the organization and within one department or unit in particular, noting relevant attributes of centralized/decentralized decision making. (3) Explain the influence of formal and informal leadership on decision making within this department or unit

REQUIRED RESOURCES

Readings

• Marquis, B. L., & Huston, C. J. (2015). Leadership roles and management functions in nursing: Theory and application(8th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.
  • Chapter 2, “Classical Views of Leadership and Management”

    The information introduced through this chapter relates to this week’s Discussion, and will also be referred to in future weeks of the course.

  • Chapter 3, “Twenty-First Century Thinking About Leadership and Management”

    This chapter examines new thinking about leadership and management and how this may influence the future of nursing.

  • Review Chapter 12, “Organizational Structure”
• Allmark, P., Baxter, S., Goyder, E., Guillaume, L. and Crofton-Martin, G. (2013), Assessing the health benefits of advice services: using research evidence and logic model methods to explore complex pathways. Health & Social Care in the Community, 21, pp. 59–68. doi:10.1111/j.1365-2524.2012.01087.x

  This manuscript examines causal pathways between the provision of advice services and improvements in health. It may also be useful to commissioners and practitioners in making decisions regarding development and commissioning of advice services.

• Downey, M., Parslow, S., & Smart, M. (2011). The hidden treasure in nursing leadership: Informal leaders. Journal of Nursing Management, 19(4), 517–521.
  Retrieved from the Walden Library databases.

  Informal leaders can have a strong impact in the workplace. This article explores the value informal leaders can provide.

• Stetler, C. B., Ritchie, J. A., Rycroft-Malone, J., & Charns, M. P. (2014). Leadership for Evidence-Based Practice: Strategic and Functional Behaviors for Institutionalizing EBP. Worldviews on Evidence-Based Nursing, 11(4), 219-226. doi:10.1111/wvn.12044

  Except from Abstract: Making evidence-based practice (EBP) a reality throughout an organization is a challenging goal in healthcare services. Leadership has been recognized as a critical element in that process. However, little is known about the exact role and function of various levels of leadership in the successful institutionalization of EBP within an organization.

Media

• Laureate Education, Inc. (Executive Producer). (2012a). Diverse organizational structures. Baltimore, MD: Author.

  Note: The approximate length of this media piece is 7 minutes.

  This week’s media pieces further explore the structure of the three organizations presented in Week 1. The experts provide additional insights into how the structure of the organization influences nursing practice and patient care.

1) Minimum 10 full pages 

2)¨**********APA norms, complet file 1

All paragraphs must be narrative and cited in the text- each paragraphs

            Bulleted responses are not accepted

            Dont write in the first person.)

3) It will be verified by Turnitin and SafeAssign

4) Minimum 5 references not older than 5 years.

5) Answer questions objectively, refrain from giving unnecessary definitions

_____________________________________________________________

Purpose:

The purpose of this Assignment is to give you a practical application to implement your PICOT idea, supported by the evidence-based research you have obtained in during your systematic review. You will apply evidence-based research findings discovered from your clinical question, and then integrate those to support your suggested change in nursing practice.

PICOT Question:

My PICOT question is ‘will off springs of diabetic patients (P), undergoing thiazolidinedione therapy (I), benefit by not becoming diabetic (O) later in life (T)?’

Directions:

1. Identify your refined PICOT question.
2. Using PubMed and the Cochrane collaboration database, do a systematic review of your clinical question.
3. Describe your systematic review and include an errors analysis.
4. Determine an evidence-based quantitative article from the search that contains an evidence-based randomized control trial.
5. Summarize the case study selected.
6. Describe the study approach, sample size, and population studied.
7. Apply the evidence from this review to your practice specifically in your overview.
8. Evaluate the outcomes, identifying the validity and reliability.
9. Discuss if the study contained any bias.
10. Determine the level of evidence identified in the review.

Topic: Best wound care approach for patients with foot ulcers

(Or it can be a different topic, but needs to be approved first)

During this lesson, you will use the PICOT questioning format/formula to develop an answerable research question. All elements are listed below:

· P: Population/disease (age, gender, ethnicity, disorder)

· I: Intervention or variable of interest (exposure to a disease, risk behavior, prognostic factor)

· C: Comparison (a placebo or “business as usual” such as no disease, absence of risk factor, or prognostic factor B)

· O: Outcome (risk of disease, accuracy of a diagnosis, rate of occurrence of adverse outcome)

· T: Time (the time it takes to demonstrate an outcome; e.g., the time it takes for the intervention to achieve an outcome or how long participants are observed)

prepare an evidence-based practice (EBP) presentation on a topic of your choice that is relevant to advanced nursing practice education, leadership, quality improvement, or change

Your presentation should include:

1. Identification of an advanced practice nursing issue or practice problem of concern

2. Design a research question using the PICOT format

3. A brief literature review and findings related to best practices with at least three scholarly resources cited in APA (6th ed.) format

4. Plan, Do, Study, Act Process that could be used

5. Any implications that the investigation might have for nursing practice

Rubric:

The presentation includes an appropriate   topic identification related to an advanced practice nursing issue or   practice problem of concern. The topic is clearly stated in the introduction,   developed and explained well through the literature review, and there is an   appropriate conclusion statement.

PICOT Question Design

Population is fully defined and present in   the research question. Includes specific interventions, identifies   comparisons, and presents appropriate outcomes in a timely manner for the   question. Overall, a well-built question using the PICOT method.

Literature Review

Includes a brief overview of the literature   in the presentation and includes relevant details.

Plan/Do/Study/Act Process

Presentation includes a description of the   study, study design, rationale, and inclusion of sampling information that   the student is using.

Implications to Nursing

The significance and applicability to   nursing is included and well presented.

Nature offers many examples of specialization and collaboration. Ant colonies and bee hives are but two examples of nature’s sophisticated organizations. Each thrives because their members specialize by tasks, divide labor, and collaborate to ensure food, safety, and general well-being of the colony or hive.

Of course, humans don’t fare too badly in this regard either. And healthcare is a great example. As specialists in the collection, access, and application of data, nurse informaticists collaborate with specialists on a regular basis to ensure that appropriate data is available to make decisions and take actions to ensure the general well-being of patients.

In this Discussion, you will reflect on your own observations of and/or experiences with informaticist collaboration. You will also propose strategies for how these collaborative experiences might be improved.

To Prepare:

• Review the Resources and reflect on the evolution of nursing informatics from a science to a nursing specialty.
• Consider your experiences with nurse Informaticists or technology specialists within your healthcare organization.

By Day 3 of Week 3

Post a description of experiences or observations about how nurse informaticists and/or data or technology specialists interact with other professionals within your healthcare organization. Suggest at least one strategy on how these interactions might be improved. Be specific and provide examples. Then, explain the impact you believe the continued evolution of nursing informatics as a specialty and/or the continued emergence of new technologies might have on professional interactions.

5 references not more than 5years

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ntroduction: Include a title slide. Next, include an introductory slide where you introduce yourself and explain what you are about to present.
Part I: The U.S. Healthcare System – Define the U.S. healthcare system by addressing the items below:

• Describe the history of the U.S. health care system. Include at least three of the revolutionary factors (e.g., teacher’s union in Dallas, Texas; the American Medical Association; Civil War, and the First Marine Hospital, etc.). Chapter two in our textbook discusses the evolution of our system and is a good resource for this part of your presentation.
• Identify at least one major development from each of the following: financial, legal, ethical, regulatory, and social [i.e., consumer demand]) that transformed the system into what it is today. You may want to revisit the health care timelines available in your course textbook.  Â
• Differentiate the stakeholders and their roles (i.e., health care professionals, clients [patients], government, colleges, and health care agencies.
  • Include the positive and negative contributions of how they affect our health care system.

Part II: The Cost of the U.S. Healthcare System

• Describe the costs and how they are set (i.e., reimbursement methods, managed care organizations, Medicare, Medicaid, and private insurance).
• Explain how technology has affected costs (e.g., EHR, medical research, equipment improvements like MRI, mammography, etc.) and delivery of quality care (e.g., personalized medicine, mobile services like ePrescribing, disease registries, etc.).

Part III: The United States Versus Other Health Care Systems—an International Perspective

• Contrast the U.S. health care system with at least one other (e.g., Canada’s universal health care vs. U.S. healthcare or South Africa vs. U.S. health care, etc.).
  • Include at least one positive aspect from the other country’s health care system that you would like to see added to the U.S. healthcare system. Explain why you would like to see this in our system.

Part IV: Reforms and Improvements

• Describe any potential reforms and improvements that are currently being discussed at either the local, state, or federal level. Your work must be based upon scholarly research, not media commentary.
  • Examples could include the following:
    • Federal modifications (i.e., Medicare reform, repealing PPACA, universal type system, etc.)
    • State modifications(i.e., Medicaid reform, income tax credits, etc.)
    • Increased consumer controls

Note: The PPACA is not an appropriate reform or improvement to be described here because it is already law and not a future improvement. However, if there is a proposal to amend or eliminate, then you can include that potential reform.

Conclusion: Future of the U.S. healthcare system

• Explain what you believe the U.S. healthcare system will look like in the next 10 years. Give at least two recommendations for change.
• Address access to care, quality of care, and cost of care including an example of each in your vision of our future healthcare system.

Creating the Final Presentation
The Final Presentation must:

• Be 15 to 20 slides, which includes Part 1, (excludes the title slide and reference slides) and formatted according to APA style as outlined in the Ashford Writing Center.
• Be presented using Microsoft PowerPoint slide presentation.  You have a choice of one of the following options for adding the narrative to your presentation. Option 1 is using voice or Option 2 is adding speaker notes to each slide.
  • Option 1: Recording your voice on each slide. You can view the tutorial using this link: adding and recording voice (Links to an external site.)Links to an external site. to each slide.You can also click on the following links to view the Accessibility Statement (Links to an external site.)Links to an external site. and Privacy Policy (Links to an external site.)Links to an external site.. If you choose this option, you must include your APA formatted citation in the speaker note section of the PPT as well.
    • Note: if you use the voice option, make sure your recordings are clear and concise. It is also important to know that adding voice narrations that are too lengthy and adding graphics may cause your PPT file to be very large (megabytes). You may have trouble loading it to Waypoint. Revisions may be necessary if this occurs.
  • Option 2: Using speaker notes for each slide in the PPT. You can review the tutorial using this link: adding speaker notes (Links to an external site.)Links to an external site. to your presentation. You can also click on the following links to view the Accessibility Statement (Links to an external site.)Links to an external site. , and the Privacy Policy (Links to an external site.)Links to an external site..Â
    • Speaker notes are the typed notes that appear below the slide that complement the presentation slides. Whereas the slides will have short bulleted items, the speaker notes will be more detailed. They are essentially what the presenter would say during the presentation to explain each of the bulleted points on the slide. Therefore, it is important that the speaker notes are concise and detailed when explaining the bullet points.

• It is recommended that PowerPoint Slides contain no more than five bullet points and should not contain more than 5 – 7 words each. Do not type paragraphs or long sentences on the slide. The information that explains each bullet point is conveyed via speaker notes or by recording your voice to each slide.
• It is required that the Microsoft PowerPoint presentation include the use of a voice or speaker notes. If you choose to use the voice capabilities within PowerPoint, you must include your citations in the speaker notes for each slide.
• Be visually engaging. For assistance with designing the visuals for your presentation, view the video Don McMillan: Life after death by PowerPoint (Links to an external site.)Links to an external site. (click on the following links to view the Accessibility Statement (Links to an external site.)Links to an external site. or the Privacy Policy (Links to an external site.)Links to an external site.) or the PowerPoint Best Practices tool.
• Include a title slide with the following:
  • Title of the presentation
  • Student name
  • Course name and number
  • Instructor name
  • Date submitted
• Address the sections in the order outlined above (Introduction, Part I, II, III, and IV).
• Present the issues with critical thought.
• Use at least two scholarly sources (none of which should be media commentary, at least one should be from the Ashford University Library).
• Document all sources in APA format (including graphics, charts and pictures that may be used within the presentation). Wikimedia Commons (Links to an external site.)Links to an external site. is a recommended source for creative commons images (to view the privacy policy, click here (Links to an external site.)Links to an external site.).
• Include a separate reference slide formatted according to APA style as outlined in the Ashford Writing Center.

If you are unable to access the technology for this assignment due to a documented accommodations on file with the Office of Access and Wellness, inform your instructor as soon as possible.Â