Leadership exam 2

  1. Name 5 major characteristics that differentiate institutional providers as well as healthcare organizations
    • types of services provided
    • length of direct care provided
    • ownership
    • teaching status
    • accreditation status
  2. Name the two types of services provided
    • general
    • special
  3. How does AHA define acute care verse chronic care
    • acute: <30 days
    • Chronic: >30 days
  4. Name 3 basic ownership forms of healthcare organizations
    • public
    • private
    • for-profit & non-profit
  5. Who does Public institutions provide health services to
    individuals under support of local, state, federal government
  6. Name 4 examples of groups of people covered under the federal level of health care
    • Veterans
    • Military
    • Native Americans
    • Inmates
  7. What is the purpose of Accountable Care organizations (ACO) and what population does it serve
    • coordinate care
    • chronic disease management
    • improve overall quality of care

    medicare recipients
  8. 5 quality measures targeted by ACO
    • experience of care
    • care coordination
    • patient safety
    • preventative health
    • frail elderly health
  9. What two types of ownership are exempt from taxes
    • federal
    • non-profit
  10. Difference between teaching institution and teaching hospital
    • TI: School or medicine & 1 other school
    • TH: Only clinical portion
  11. What are 3 issues with hospitals wanting to have a teaching program
    • Salaries of physicians to supervise
    • Duplicated tests/procedures
    • Delays in processing patients
  12. What is economic performance like for teaching verse non-teaching hospitals
  13. Name some programs that the Joint Commission accredits
    • Ambulatory care
    • behavioral health
    • Acute care/Critical access hospitals
    • Lab services
    • Long-term care
    • hospital-based surgery
  14. Name 5 levels of consolidated systems
    • Large national hospitals
    • Large voluntary systems
    • Regional hospital
    • Metropolitan-based
    • Special interest groups
  15. Name 3 organizational models for health networks
    • Public utilities
    • For-profit businesses
    • Loose affiliations
  16. How does managed care help reduce cost of expensive acute hospital care
    • combine care delivery with financing
    • provide comprehensive services at fixed prepaid fee
    • Focus on preventative care and follow-up
  17. What criteria needs to be met for HMO to be federally qualified
    • offer inpatient/outpatient care
    • treatment/referral for drug & alcohol
    • lab/radiology
    • preventative dental children <12
    • preventative health
    • physician services
  18. What is IPA
    group practice in which physicians in private offices are paid on fee-for-service
  19. What is PPO
    Fees are discounted for patients in return for physicians getting prompt payment
  20. Name some examples of free-standing organizations
    • Surgicenters
    • Urgent Care
    • Primary Care
    • Imaging centers
  21. What are funds used for that are supplied to public health departments from local, state, or federal budgets
    • maternal/child care
    • communicable diseases
    • children with birth defects
    • mental health
    • bioterrorism investigation
    • Environmental services
  22. What is the fastest growing segments of health care
    home care
  23. Name 5 examples of regulatory organizations
    • Medicaid/Medicare
    • FDA
    • OSHA
    • Equal employment
    • State licensing boards
  24. What is the country's largest and most influential health insurance program
  25. Who is the primary payer of healthcare costs in the US
    federal government
  26. What is the approval, recognition, or certification by an official review board that an organization has met certain standards
  27. What is deeming authority
    an organization that is surveyed and accredited by a national accrediting body for CMS
  28. What is it called when organizations that provide similar services come together
    horizontal integration
  29. What is it called when organizations align to provide a full array or continuum of services
    vertical integration
  30. What is the difference between acquisitions and mergers
    • A: one organization buys another
    • M: combining 2+ organizations to form new entity
  31. Name the 3 major driving forces for the evolution of healthcare organizations
    • economic
    • social
    • demographics
  32. Name 2 types of systems in the systems theory
    • Closed (self-contained)
    • Open (interacting with internal/external forces)
  33. Name 3 things comprising the framework for systems theory
    • Inputs
    • Throughputs
    • Outputs
  34. Name 4 elements of systems theory
    • Structure
    • Technology
    • People
    • Environment
  35. Difference between open and closed systems in system theory
    • Open: continual process of adaptation
    • Closed: sufficient to self, not affected by what happens around it
  36. What theory sees the universe as filled with unpredictable and random events; requires organizations to be self-organizing and adaptive to survive
    Chaos theory
  37. What is a systematic analysis of how organizations and their component parts act and interact
    Organizational theory
  38. What 3 things does organizational theory look at
    • culture
    • technology
    • structure/development
  39. Difference between mission and vision
    • M: Reason for existence
    • V: Articulated goal, future, purpose
  40. What is included in the mission statement
    • Customers
    • Types of service
    • Technology/human resources
  41. What does the mission focus on for hospitals? Ambulatory Care? Long-term? Nursing centers?
    • H: treatment
    • A: treatment, prevention, diagnosis
    • LT: maintenance, social support
    • NC: promote optimal health status
  42. What is the guiding framework for decision-making
  43. What is the reflection of the norms or traditions of an organization
    organization culture
  44. What two ways is culture demonstrated
    • mutually reinforcing
    • conflict-producing
  45. To most people, what reflects the true organizational culture
    lived experience
  46. What defines how work is organized, where decisions are made, and the authority and responsibility of workers? Provides map for communication
    Organizational structure
  47. What theory today best explains nursing organizational development
    Chaos theory (nonlinear, complex, quantum)
  48. What is a tool that consumers can use to access a searchable database of information describing how well hospitals care for patients
    Hospital Compare
  49. Name 3 factors that influence structural design
    • Federal mandates
    • Consumerism
    • Competition
  50. Name 3 techniques in redeveloping structural designs
    • Redesign
    • Restructure
    • Re-engineer
  51. What technique is used to analyze tasks to improve efficiency
  52. What technique is used to enhance organizational productivity
  53. What involves the total overhaul of an organizational structure
  54. What is an example of redesigning the work environment from the bottom up?
    Transforming care at the bedside
  55. What 3 characteristics classify organizational designs
    • complexity
    • formalization
    • centralization
  56. What concerns the division of labor, specialization of labor, number of hierarchical levels, and geographic dispersion of units
  57. What is the separation of processes into tasks that are performed by designated people
    division of labor and specialization
  58. Difference between hierarchy and chain of command
    • H: line of authority/responsibility
    • COC: Vertical dimension of hierarchy
  59. What is span of control
    # of subordinates a supervisor managers
  60. What is the degree to which an organization has rules stated in terms of policies that define a members function
  61. What is the location where a decision is made
  62. Difference between centralized and decentralized institutions
    • C: Hierarchy makes decisions
    • D: lower level makes decisions (direct care nurse)
  63. What is the centralization of authority in administrative bureaus or government departments
  64. Benefits verse risk of bureaucracy
    • Benefit: consistency
    • Risk: limit autonomy, treatment delays
  65. What could be assessed to determine the level of bureaucracy present in an organization
    • Labor specialization
    • Centralization
    • Formalization
  66. How is labor specialization assessed to determine the level of bureaucracy present in an organization
    degree to which patient care is divided into highly specialized tasks
  67. How is centralization assessed to determine the level of bureaucracy present in an organization
    level of organization on which decisions regarding carrying out work and remuneration for work are made
  68. How is formalization assessed to determine the level of bureaucracy present in an organization
    % of actions required to deliver patient care that is governed by written policy and procedures
  69. Difference between line functions and staff functions
    • Line: direct responsibility, decision making
    • Staff: support, advice, council
  70. Name 4 types of organizational structures
    • Functional
    • Service
    • Matrix
    • Flat
  71. What structure arranges departments and services according to specialty
  72. Benefit verse risk of functional structures
    • Benefit: support expertise, encourage advancement
    • Risk: Discontinuity of pt care services
  73. What structure has a single manager or executive
  74. benefit verse risk of service-line structure
    • B: coordination of services, expedited decision making, clarity of purpose
    • R: duplication of services, loss of professional/technical affiliation, lack of standardization
  75. What structure has a complex design that reflects both function and service in an integrated organizational structure? Manager of unit reports to functional and service-line manager
  76. What structure eliminates hierarchy by allowing delegation of decision making to the professionals doing the work
  77. What are benefits and risks of Flat structures
    • B: autonomy, speedy car
    • R: inconsistency, loss of growth opportunities
  78. 4 inherent characteristics of culture
    • develops over time, responsive
    • learn it and share it
    • essential for survival/acceptance
    • changes with difficulty
  79. Difference between culture diversity and culture sensitivity
    • D: differences
    • S: affect (feelings)
  80. 3 themes involved in acculturation
    • Socialization
    • Acculturation
    • Assimilation
  81. What refers to adapting a a particular culture
  82. What refers to individuals who now define themselves as members of the dominant culture
  83. 3 things that could occur according to Spence when working with someone of a different culture
    • Prejudice
    • Paradox
    • Possibility
  84. describe the model of cultural competence
    • Outer: global society
    • Second: community
    • Third: Family
    • Inner: person
  85. What is included in Transcultural Assessment Model
    • communication
    • time
    • space
    • social organization
    • environment
    • biological variations
  86. What theory focuses explicitly on close relationships of the culture, emic and etic congruency
    Sunrise model, Leninger theory of transcultural nursing
  87. What is bridging of gaps between cultures
  88. What was formed to bring together nursing stakeholders to develop shared vision, strategies, and specific actions for improvement in nursing practice, education, and delivery of patient care through the use of information health technology
  89. 3 parts of TIGER
    • basic computer competencies
    • information literacy
    • information management
  90. name 4 things included in biomedical technology
    • physiologic monitoring
    • diagnostic testing
    • IV fluid & meds
    • Therapeutic regimen
  91. How does knowledge technology assist in pt care
    generates knowledge to provide clinical decision support
  92. What is the set of standards defined by Medicaid/Medicare EHR incentive programs that govern the use of EHRs
    Meaningful use
  93. 3 benefits of meaningful use of EHR
    • Complete and accurate info
    • Better access to info
    • Pt empowerment
  94. What includes annual records of medication errors
  95. What type of care delivery strategies has one nurse that provides total care of the patient? What setting is this seen
    • Case method
    • CC
  96. Benefits/risks of Case method
    • B: consistent care, continuity, subtle changes easily noticed
    • R: Very expensive, not enough resources
  97. What delivery of care method involves providing patient care by each licensed/unlicensed staff member by performing specific tasks for a large group of pts
  98. Benefits/Risks of Functional Model of nursing in delivery of care methods
    • B: task efficiency, much work done in short time, fixed RN and large UAP
    • R: Fragmentation of care, ineffective communication
  99. What delivery of care model works best in disaster/emergency situations
  100. What is team nursing
    • Team leader assigns staff in team, reports to charge nurse
    • Provides care to a small group of patients
  101. Benefits/risks of team nursing
    • B: organizational decisions made at lower levels, cost-effectiveness
    • R: team leader with poor communication skills, careful for it not to become functional like, potential for fragmentation high
  102. What is primary nursing
    1 RN assigned to patients for 24 hours, assistant RN reports changes and primary nurse makes adjustments
  103. Where is primary nursing hybrid: partnership model appropriate
    with other disciplines in close proximity
  104. What is a critical pathway
    standard plan of care for various diseases that outline a normal progression. If there are variances, treatment should be adjusted
  105. Difference between case manager and nurse navigator
    • CM: variety of conditions, long term
    • NN: single health condition, acute
  106. 5 stages of Dreyfus model of skill acquisition
    • novice
    • advanced beginner
    • competent
    • proficient
    • expert
  107. How many years of work for a nurse to reach competency in Dreyfus model of skill acquisition
    2-3 years
  108. 4 objectives of TCAB
    • Reliability
    • Vitality
    • Pt-centeredness
    • Increased value
  109. What factors should be considered when developing a new model for delivery of care
    • Trends in healthcare
    • Wants/needs of people
    • structural/process/outcome decisions
    • Need to be sustainable over time and able to replicate
  110. Difference between prototype and factor evaluation systems
    • P: subjective and descriptive, single healthcare focus
    • F: Objective, complex health issues
  111. What is input and output for productivity in nursing
    • Input: employees
    • Output: # of beds
  112. What is a comprehensive, national database that provides hospitals with nursing unit level comparison on 18 quality indicators that can be used in quality improvement plans to prevent adverse effects
  113. What is the Registered Nurse Safer Staffing Act
    all acute care hospitals have to establish a committee made up of 55% direct care RNs
  114. # of units of service for the reporting period
    Volume statistic
  115. # of beds or blocks of time available for providing services
    Capacity statistics
  116. 5 communication patterns in response to stress
    • attribution of blame
    • placation
    • Constrained cool-headedness
    • immaterial irrelevance
    • congruence
  117. When human beings are in distress, what conditioned responses occur (3)
    • blame (feelings)
    • Judgement (thinking)
    • Demand (unreasonable)
  118. 5 key behaviors of leaders building a high-performance team
    • model
    • inspire
    • challenge
    • enable
    • encourage
  119. 5 guidelines for acknowledgement
    • specific
    • personal
    • sincere
    • public
    • timely
  120. What is it called when people work together to produce extraordinary results
  121. What is dualism
    things are black or white
  122. what is reflective practice
    learn from experience
  123. what is the greatest deterrent to self-esteem and self-confidence
  124. What integrated program stresses teamwork and communication between physicians, nurses, and other healthcare personnel to increase pt safety
  125. What 3 parts make up nursing informatics
    • data
    • info
    • knowledge
  126. What are the 3 most common reasons there are errors made r/t technology
    • mislabeled bar codes
    • mistakes at order entry
    • issues with management of info
  127. Name 5 phases of team development
    • Forming
    • Storming
    • Norming
    • Performing
    • Adjoining
  128. What phase of team development includes a period of confusion
  129. What phase of team development will some team members leave and some join
  130. 3 things that kill synergy
    • self-appointed expert
    • someone who doesnt speak up
    • loner
  131. Characteristics of veterans
    • support status quo
    • accepts authority
    • appreciates hierarchy
    • loyal to employer
  132. Characteristics of baby boomers
    • workaholics
    • struggle with new technology
  133. characteristics of generation X
    • adapts easily to change
    • personal life/family important
    • frequent job changes
    • proficient in technology
  134. characteristics of generation Y
    • Optimistic & self-confident
    • values achievement
    • Technology way of life
    • at ease with diversity
  135. behavioral change strategy where the manager provides factual info to support the change
  136. When would rational-empirical be used
    when resistance to change is minimal
  137. behavioral strategy where the manager focuses on interpersonal relationships to promote change
  138. behavioral strategy where the manager uses rewards to promote change
  139. When would power-coercive be used
    individuals highly resistant to change
  140. 4 types of decision making styles
    • decisive
    • flexible
    • hierarchical
    • integrative
  141. Treatment of inhaled anthrax
    • Cipro
    • 2 antibiotics
  142. treatment of cutaneous anthrax
    • cipro
    • doxycycline
  143. Treatment of botulism
    • airway management
    • antitoxin
  144. treatment of ebola
    • minimize invasive procedures
    • supportive care
  145. Treatment for plague
    • antibiotics within 24 hours to prevent death
    • Streptomycin, gentamycin, chloramphenicol
  146. Treatment of smallpox
    supportive (skin care, meds for pain/fever, prevent dehydration)
  147. Treatment of Tulaermia
    • streptomycin/gentamicin
    • Mass: doxycycline or cipro
  148. sore throat, fever, cough, SOB, muscle aches, severe dyspnea, meningitis, shock indicates:
    inhalation anthrax
  149. starts as lesion and becomes itchy, develops into vesicular lesion that becomes necrotic with formation of black eschar, fever, chills indicates:
    Cutaneous anthrax
  150. dysphagia, double vision, slurred speech, descending progressive weakness, n/v/abd cramps, dyspnea indicate what
  151. sore throat, HIGH fever, n/v/d, internal/external bleeding indicate what
  152. first signs fever, HA, weakness, rapidly developing pneumonia, bloody or water sputum, chest pain indicate what
    pneumonic plague
  153. swollen tender lymph glands, fever, HA, chills, weakness indicate what
    Bubonic plague
  154. fever, chills, prostration, abd pain, shock, bleeding into skin and other organs indicate what
    septicemic plague
  155. high fever, fatigue, severe HA, RASH, chills, vomiting, delirium indicate what
  156. sudden fever, chills, HA, diarrhea, muscle aches, joint pain, dry cough, progressive weakness, if airborne can develop life-threatening pneumonia and systemic infection
Card Set
Leadership exam 2