Organizational Systems and Quality Leadership

C489 – Organizational Systems and Quality Leadership
Course of Study This course supports the assessment for Organizational Systems and Quality Leadership. The course covers 4 competencies and represents 3 competency units.
Introduction
Overview Nurses serve as clinicians, managers, and mentors to shape the future of healthcare and impact patient care outcomes in positive ways. This course will help students to be more confident and better prepared to assume leadership roles regardless of their position in the healthcare delivery system. This advanced leadership course focuses on the concepts of patient safety, improvement science, balancing cost, quality and access through the triple aim, leadership and patient/family centered care. Students will develop mastery of advanced competencies particularly in patient safety in quality improvement science. Watch the following video for an introduction to this course:
Note: To download this video, right-click the following link and choose “Save as…”: download
video.
Competencies This course provides guidance to help you demonstrate the following 4 competencies:
Competency 734.3.1: Principles of Leadership The graduate applies principles of leadership to promote high-quality healthcare in a variety of settings through the application of sound leadership principles.
Competency 734.3.2: Interdisciplinary Collaboration The graduate applies theoretical principles necessary for effective participation in an interdisciplinary team.
Competency 734.3.3: Quality and Patient Safety The graduate applies quality improvement processes intended to achieve optimal healthcare outcomes, contributing to and supporting a culture of safety.
Competency 734.3.4: Healthcare Utilization and Finance The graduate analyzes financial implications related to healthcare delivery, reimbursement, access, and national initiatives.
Preparing for Success The information in this section is provided to detail the resources available for you to use as you complete this course.
Learning Resources The learning resources listed in this section are required to complete the activities in this course. For many resources, WGU has provided automatic access through the course. However, you may need to manually enroll in or independently acquire other resources. Read the full instructions provided to ensure that you have access to all of your resources in a timely manner.
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C489 – Organizational Systems and Quality Leadership
Course of Study
Automatically Enrolled Learning Resources You will be automatically enrolled at the activity level for the following learning resources. Simply click on the links provided in the activities to access the learning materials.
VitalSource E-Text The following textbook is available to you as an e-text within this course. You will be directly linked to the specific readings required within the activities that follow.
Cherry, B., & Jacob, S. (2014). Contemporary nursing: Issues, trends, and management
(6th ed.). St. Louis: Mosby Elsevier. ISBN: 978-0-323-101097.
Note: This e-text is available to you as part of your program tuition and fees, but you may
purchase a hard copy at your own expense through a retailer of your choice. If you choose to do
so, please use the ISBN listed to ensure that you receive the correct edition.
Elsevier Evolve Online Course Elsevier Evolve is the online companion site to the Contemporary nursing: Issues, trends, and
management textbook. This course of study will directly link you to specific activities within Evolve. Cherry: Contemporary Nursing: Issues, Trends, and Management (4th ed.)
Other Learning Resources You will use the following learning resources for this course of study.
IHI Open School Courses If you do not have an IHI account, you will need to create one. Please review the “Working with
IHI” guide. This tutorial will guide you in creating an account and accessing the required learning modules. This course of study will require you to complete all the modules necessary to obtain the IHI
Basic Certificate of Completion. Once completed, you will need to save a copy to upload to Taskstream as part of this course and as part of your Professional Portfolio (Prelicensure and RN to BSN students only). The provided instructions will guide you through locating and downloading the certificate of completion. While there are numerous modules, you will only upload the single certificate that indicates you have completed all the modules. If you are a registered nurse, you may also apply for continuing education credit for the lessons completed in IHI.
Nursing Standards You will be able to access Nursing Professional Standards as they apply to your program through the WGU Library. Please access these documents at the following website:
Nursing Standards E-Reserves
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C489 – Organizational Systems and Quality Leadership
Course of Study
Leadership and Management Nurses, regardless of the position they hold, are leaders when they use their knowledge and skills in the provision of high quality patient care. In this section you will learn key concepts related to leadership and management that are essential for the delivery of safe and effective patient centered care. The terms “leadership” and “management” are often used interchangeably, but they are not the same. You will be introduced to leadership and management skills and styles that will be most helpful to you in your role as a professional nurse.
Issues, Trends, and Management Leadership and management are complex and also continually changing concepts. While certain basic assumptions and ideas remain constant, many methods and practices alter and develop as cultures change. This topic addresses the following competency:
Competency 734.3.1: Principles of Leadership The graduate applies principles of leadership to promote high-quality healthcare in a variety of settings through the application of sound leadership principles. This topic highlights the following objectives: Prepare resources that enhance management and leadership skills. Document the impact change theory has on the spread of new ideas in a population. Apply strategies enabling individuals to exert leadership without occupying a formal leadership position. Compare and contrast types of team-building skills needed for effective interdisciplinary coordination of patient care. Apply strategies for persuading and supporting others to effect change. Examine the relationship between leadership and management theories and specific nursing leadership, including nursing activities drawn from with each theory.
Triple Aim for Populations In this lesson, we introduce you to what’s involved in improving population health. To combat many of the most important threats to human health, it’s not enough to improve clinical care for only one patient at a time; we must understand the broader influence of education, the environment, and wealth distribution on health outcomes. Complete the following IHI Open School: TA 101: Introduction to the Triple Aim for Populations
Nursing Leadership Management Read the following chapter in Contemporary Nursing:
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C489 – Organizational Systems and Quality Leadership
Course of Study
chapter 16 Nursing Leadership and Management Access the Evolve Contemporary Nursing online course and complete the following module (note: the module number is not the same as the chapter number):
module 15: Nursing Leadership and Management lessons 1–5
IHI Open School Access IHI Open School and complete the following courses: PFC 101: Introduction to Patient – Centered Care L101: Introduction to Health Care Leadership
Change Theory A change that seems practical and beneficial to you may seem unreasonable to others. Learning to implement change by helping others adopt change can facilitate efforts to improve throughout your organization. In this section, we will explore the concept of change theory, based on the foundational work of psychologist Kurt Lewin and sociologist Everett Rogers. As you review the material, consider how you might utilize these strategies to motivate change-resistant individuals and develop new ideas more likely to spread across a population. Complete the following IHI Open School: QI 201: Planning for Spread: From Local Improvements to System-Wide Changes
Essentials of Collaborative Practice As a professional nurse, being able to effectively communicate with colleagues and having the necessary conflict resolution skills are critical for the delivery of safe patient care. In this section you will learn about communication techniques that can prevent conflict and strategies that have been proven effective in building trusting collaborative relationships. This topic addresses the following competency:
Competency 734.3.2: Interdisciplinary Collaboration The graduate applies theoretical principles necessary for effective participation in an interdisciplinary team. This topic highlights the following objectives: Identify factors that may influence the communication process. Examine the influence interdisciplinary teams have on quality improvement, safety, and improving patient outcomes. Examine the importance of nurses taking an active, contributing position within the interdisciplinary team. Apply strategies for effectively participating with interdisciplinary team members.
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C489 – Organizational Systems and Quality Leadership
Course of Study Apply evidence-based strategies used to optimize communication and teamwork in interdisciplinary teams. Create a plan for health quality and safe patient care from the perspective of a member of an interdisciplinary team.
Effective Communication and Conflict Resolution Read the following chapter in Contemporary Nursing:
chapter 18 Effective Communication and Conflict Resolution Access the Evolve Contemporary Nursing online course and complete the following module (note: that the module number is not the same as the chapter number):
module 17: Effective Communication and Conflict Resolution lessons 1-5
Optimizing Communication and Teamwork How do we engage nurses at the bedside to become more creative about designing safety and quality processes? The Robert Wood Johnson Foundation (RWJF) and the Institute for Healthcare Improvement (IHI) did just that with the launch of Transforming Care at the Bedside (TCAB). This national, innovative initiative was designed to improve the work environment of medical/surgical units by implementing changes that would improve patient outcomes and staff satisfaction. The changes focus on strategic applications of improved communication techniques across multiple disciplines, including nurses, physicians, and other clinical and support staff. Review the initiative at the website below:
TCAB – Transforming Care at the Bedside
Creating a Culture of Safety for Quality Patient Care Medical errors are one of the nation’s leading causes of death and injury. Communication regarding safety issues and errors needs to be clear and honest. Process improvement strategies help nurses focus on resolving the problem rather than merely giving or receiving blame.Patient Safety First In this section, you will watch prominent clinicians describe the errors they have made and how those errors still haunt them today. Errors can be significant learning opportunities as they point out measures that can be implemented to reduce the likelihood of reoccurrences. This topic addresses the following competency:Competency 734.3.3: Quality and Patient Safety The graduate applies quality improvement processes intended to achieve optimal healthcare outcomes, contributing to and supporting a culture of safety. This topic highlights the following objectives:5 / 15C489 – Organizational Systems and Quality LeadershipCourse of Study Document the primary types and causes of errors in organizations. Examine behaviors nurses engage in to improve the safety of patients in their direct care. Describe how adverse events can be used as learning opportunities.IHI Open School: The Mistake, Introduction to Patient Safety, and Fundamentals ofPatient Safety Read the following chapter in Contemporary Nursing:chapter 21 Quality Improvement and Patient Safety IHI Open School: The Mistake, Introduction to Patient Safety, and Fundamentals of Patient Safety Access IHI Open School and watch the following two videos:Learning from Medical Errors (Part 1) (8:35)Learning from Medical Errors (Part 2) (7:57)Note: These videos are in addition to the courses found in the IHI Basic Course. Complete the following IHI Open School Courses on Patient Safety: PS 101: Introduction to Patient Safety PS 102: From Error to HarmIHI Open School: Overcoming Barriers to Error Disclosure Besides being deadly, medical errors can also be a source of great injury and sufferings for patients and their families. Many barriers exist to discourage the open, honest disclosure of errors in the healthcare settings. In this section, you will view three short videos dealing with this important topic. Access IHI Open School: Watch the following 3-part series (see side panel for links to Part 2 and Part 3): The Patient and the Anesthesiologist, Part 1: The Incident The Patient and the Anesthesiologist, Part 2: The Connection The Patient and the Anesthesiologist, Part 3: The Experts ReactNote: These videos are in addition to the courses found in the IHI Basic Course. Complete the following in IHI Open School: PS 103: Human Factors and Safety PS 104: Teamwork and Communication in a Culture of Safety6 / 15C489 – Organizational Systems and Quality LeadershipCourse of StudyInitiatives, Strategies and Tools to Ensure Safe, Quality PatientCare In this section, we will explore some initiatives such as the National Safety Patient Goals and safety tools that are being increasingly used to provide safe care. As you review this section, reflect on how you may use these initiatives, strategies and tools to improve your patient outcomes. This topic addresses the following competency:Competency 734.3.3: Quality and Patient Safety The graduate applies quality improvement processes intended to achieve optimal healthcare outcomes, contributing to and supporting a culture of safety. This topic highlights the following objectives: Examine behaviors nurses engage in to improve the safety of patients in their direct care. Determine the tools and skills necessary for effective quality improvement activities.National Patient Safety Goals According to the Joint Commission, the purpose of the National Patient Safety Goals (NPSGs) is to improve patient safety. The Goals focus on problems in health care safety and how to solve them and have specific requirements for protecting patients. As you review the goals, you will notice that patient safety measures indicated for each goal are measures that you have already learned and are implementing in your respective health care settings. You will also notice that significant focus has been placed on the most pressing patient safety issues that all organizations are struggling to manage effectively.Nursing Quality Indicators Also known as Nursing Sensitive Indicators, nursing quality indicators reflect the impact that nursing has on patient care. Watch the following video, Nursing Sensitive Indicators [Sauls, K. (November 18, 2013], for more information:Note: To download this video, right-click the following link and choose “Save as…”: downloadvideo.The Checklist Manifesto The implementation of a low-cost checklist can drastically improve patient outcomes by helping to prevent patient errors. This topic addresses the following competency:7 / 15C489 – Organizational Systems and Quality LeadershipCourse of StudyCompetency 734.3.3: Quality and Patient Safety The graduate applies quality improvement processes intended to achieve optimal healthcare outcomes, contributing to and supporting a culture of safety. This topic highlights the following objectives: Examine behaviors nurses engage in to improve the safety of patients in their direct care. Determine the tools and skills necessary for effective quality improvement activities.The Checklist Manifesto: How to Get Things Right Access and view the following videos:Note: To download this video, right-click the following link and choose “Save as…”: downloadvideo.Note: To download this video, right-click the following link and choose “Save as…”: downloadvideo. You are strongly encouraged to read this book: Gawande, A. (2007). Better: A Surgeon’s Notes on Performance. NY: Henry Holt and Company. ISBN-13:978-0-312-42765-8Bundling Recent data has shown dramatic success in improving the quality of patient care by focusing on the implementation of an entire group or bundle of evidenced-based practices to achieve a better outcome than when implemented individually. This new process is referred to as “bundling” of evidence-based practices. This topic addresses the following competency:Competency 734.3.3: Quality and Patient Safety The graduate applies quality improvement processes intended to achieve optimal healthcare outcomes, contributing to and supporting a culture of safety. This topic highlights the following objective: Describe how the use of bundling practices can improve patient healthcare outcomes.Bundling: Evidence-Based Practices Access and read the following:Evidence-Based Bundle Increases Adherence to Recommended Practices, Leading to8 / 15C489 – Organizational Systems and Quality LeadershipCourse of StudyFewer Central Line Infections and Lower Hospital CostsGetting to the Root Cause of Medical Errors: A SystemsApproach It is now commonly accepted that the majority of errors result from problems in the system and not necessarily individual behaviors. This section will focus on getting to the root of medical errors. In this section you will learn how a system may contribute to either a safe working environment or barriers to patient safety and quality care. You can then use systems tools and strategies to join healthcare colleagues in the creation and building of a culture of safety.Systems Thinking in Healthcare Concepts of systems theory, thinking and tools are the underpinnings for our understanding of root cause of medical errors and in the continuing efforts to prevent errors from occurring. This topic addresses the following competency:Competency 734.3.3: Quality and Patient Safety The graduate applies quality improvement processes intended to achieve optimal healthcare outcomes, contributing to and supporting a culture of safety. This topic highlights the following objectives: Apply best practices for utilizing a systems approach to prevent medical errors. Determine the human and fiscal resource impact of medical errors on patients, families, practitioners and the healthcare industry. Determine the professional nurse’s role in reducing medical errors and improving healthcare quality. Apply a root cause analysis method to address a system problem in healthcare.Importance of Systems Thinking in Healthcare Access the Systems Thinking and Systems Tools website and read the following: Systems Thinking Systems Thinking in Organizations Organizations as Open Systems Five Disciplines of Systems Thinking – per Peter Senge Some Applications of Systems TheoryRoot Cause Analysis The key to solving a problem is to first truly understand it. Often, we try to solve a problem before completely comprehending its cause, and the focus shifts too quickly from the problem to the solution. A root cause analysis can help you determine the issue, avoid quick fixes and tackle chronic concerns in a system. Access and read the following:9 / 15C489 – Organizational Systems and Quality LeadershipCourse of StudyAsk “Why” Five Times to Get to the Root CauseIncluding patients in root cause and system failure analysis: Legal and psychologicalImplications. Click on the “View Article” button on the lower left side to access the complete article.The Unfortunate Admission The documents for the case study are linked in the “Documents” box. Read the case study first. Next review the PowerPoint slides of the winning student team that conducted the root cause analysis on the case study.IHI Open School: Root Cause and System Analysis, Communication with Patients AfterAdverse Effects, & Introduction to the Culture of Safety Complete the following IHI Open School: PS 105: Responding to Adverse EventsFailure Modes and Effects Analysis The Root Cause Analysis (RCA) is a reactive process that looks back at past events to determine their causes and initiate a plan of action to correct those causes in order to prevent a recurrence. In contrast, the Failure Modes and Effects Analysis is a proactive process that looks ahead to anticipate ways in which potential errors may occur and to initiate a plan of action to prevent them before they have a chance to occur. This topic addresses the following competency:Competency 734.3.3: Quality and Patient Safety The graduate applies quality improvement processes intended to achieve optimal healthcare outcomes, contributing to and supporting a culture of safety. This topic highlights the following objectives: Apply best practices for utilizing a systems approach to prevent medical errors. Determine the professional nurse’s role in reducing medical errors and improving healthcare quality.Failures Modes and Effects Analysis Watch the following video, Failure Modes and Effects Analysis [Sauls, K. (November 18, 2013) ], for an overview of the FMEA process:Note: To download this video, right-click the following link and choose “Save as…”: downloadvideo.10 / 15C489 – Organizational Systems and Quality LeadershipCourse of Study Review the following information from the IHI website for additional details: “Failures Modes and Effects Analysis” Scroll down to the documents section to download and review the “FMEA Tool”Basic Principles of Safety, Quality Improvement andChange In this section, you will examine principles relevant to the provision of safe, quality care, improvement, and change. Understanding and applying best practices gained from the national quality and safety initiatives help to ensure a safe healthcare environment and the provision of quality care. Quality improvement is a necessary process in any business or industry but may be most important when dealing with people’s lives as healthcare professionals do. An understanding of principles such as process improvement, clinical indicators, and standardized care processes is essential for the provision of safe, timely, effective, efficient, equitable, and patient-centered care.Quality Improvement and Patient Safety Quality improvement is a necessary process in any business or industry but may be most important when dealing with people’s lives as healthcare professionals do. An understanding of principles such as process improvement, clinical indicators, and standardized care processes is essential for the provision of safe, timely, effective, efficient, equitable, and patient-centered care. This topic addresses the following competency:Competency 734.3.3: Quality and Patient Safety The graduate applies quality improvement processes intended to achieve optimal healthcare outcomes, contributing to and supporting a culture of safety. This topic highlights the following objective: Determine the professional nurse’s role in ensuring patient safety and improving healthcare quality.Quality Improvement and Patient Safety Review the following chapter in Contemporary Nursing:chapter 21 Quality Improvement and Patient Safety Access the Evolve Contemporary Nursing online course and complete the following module (note: that the module number is not the same as the chapter number):module 20: Quality Improvement and Patient Safety lessons 1-511 / 15C489 – Organizational Systems and Quality LeadershipCourse of Study Complete the following IHI Open School: QI 101: Introduction to Health Care Improvement QI 102: How to Improve with the Model for Improvement QI 103: Testing and Measuring Changes with PDSA Cycles QI 104: Interpreting Data: Run Charts, Control Charts, and other Measurement Tools QI 105: Leading Quality ImprovementStaffing and Nursing Delivery Models The ability to provide safe patient-centered care is dependent upon many factors. As a professional nurse, it’s important to be knowledgeable about the illness of the patients, the amount of nursing time available, the care delivery model, care management tools, and organizational support needed to facilitate care.Staffing and Nursing Care Delivery An important skill of the nurse leader is to ensure that staffing patterns are effective for safe, patient-centered care. Patient factors that must be considered in developing staffing schedules, staff and environmental factors, and how staffing patterns are impacted by the unit’s delivery model are some of the issues addressed in this section. This topic addresses the following competency:Competency 734.3.3: Quality and Patient Safety The graduate applies quality improvement processes intended to achieve optimal healthcare outcomes, contributing to and supporting a culture of safety. This topic highlights the following objectives: Determine the impact of staffing and staff mix on patient care, staff satisfaction and the organization’s financial status. Determine the role of the professional nurse in considering individuals, populations, and cost in healthcare outcomes.Staffing and Nursing Care Delivery Models Read the following chapter in Contemporary Nursing:chapter 20 Staffing and Nursing Care Delivery Models Access the Evolve Contemporary Nursing online course and complete the following module (note: that the module number is not the same as the chapter number):module 19: Staffing and Nursing Care Delivery Models lessons 1-5Healthcare Cost in America12 / 15C489 – Organizational Systems and Quality LeadershipCourse of Study Healthcare cost in America is a major economic and political concern. This section will discuss your role as a professional nurse in terms of cost containment and how health care economics affect professional nurses.Healthcare Delivery System: Resources and FinancingImplications The delivery of healthcare in America differs significantly from countries around the world. This section will compare the perspectives of healthcare providers in the United States with those in countries in which healthcare is affordable and accessible to most of its citizens. This topic addresses the following competency:Competency 734.3.4: Healthcare Utilization and Finance The graduate applies financial implications related to healthcare delivery, reimbursement, access, and national initiatives. This topic highlights the following objectives: Compare and contrast U.S. healthcare cost and delivery with other comparable nations. Analyze how national healthcare policies influence healthcare delivery in the United States.Healthcare Delivery System: Resources and Financing Implications This section will examine the concepts of healthcare utilization management and healthcare financing. It will include an overview of economic issues and trends driving changes in healthcare delivery, how healthcare is paid for, and how these issues affect nursing. The delivery of healthcare in America differs significantly from countries around the world. This section will compare the perspectives of healthcare providers in the United States with those in countries in which healthcare is affordable and accessible to most of its citizens. View the following videos:PBS Frontline: Sick Around the World Select one of the five countries in the Frontline report and compare healthcare cost of your selected country with healthcare cost in the United States. Post your comparison in your study notes. Did the comparisons of healthcare cost and delivery around the world change or influence your perspective about national health coverage?Healthcare Cost and Quality Balancing cost and quality presents many ethical concerns for professional nurses. This topic addresses the following competency:Competency 734.3.4: Healthcare Utilization and Finance The graduate applies financial implications related to healthcare delivery, reimbursement, access, and national initiatives.13 / 15C489 – Organizational Systems and Quality LeadershipCourse of Study This topic highlights the following objectives: Examine the challenges of Americans with critical illnesses lacking healthcare coverage. Analyze the role of the professional nurse in helping patients understand their insurance options. Analyze policy issues that affect reimbursement for hospital-acquired infections. Analyze how national healthcare policies influence healthcare delivery in the United States. Analyze the ethical implications of inefficiencies in fiscal or resource allocation.Ethics Toolbox: Healthcare Cost and Quality Access and read the following:Healthcare Cost and Quality Read the following chapter in Contemporary Nursing:chapter 7 Paying for Healthcare in America: Rising Cost and Challenges Access the Evolve Contemporary Nursing online course and complete the following module (note: that the module number is not the same as the chapter number):module 7: Paying for Healthcare in America: Rising Cost and Challenges lessons 1-5ATI Review for Pre-Licensure Students Preparing for NCLEX If you are a pre-licensure student and you have already completed Professional Roles and Values, this would be a good time to take the ATI RN Leadership Online Practice test. Access your ATI account and see how much you have learned in this course.Final Steps Congratulations on completing the activities in this course! This course has prepared you to complete the assessment associated with this course. If you have not already been directed to complete the assessment, schedule and complete your assessment now.Accessibility Policy Western Governors University recognizes and fulfills its obligations under the Americans with Disabilities Act of 1990 (ADA), the Rehabilitation Act of 1973 and similar state laws. Western Governors University is committed to provide reasonable accommodation(s) to qualified disabled learners in University programs and activities as is required by applicable law(s). The Office of Student Accessibility Services serves as the principal point of contact for students seeking accommodations and can be contacted at ADASupport@wgu.edu. Further information on WGU’s Accessibility policy and process can be viewed in the student handbook at the following link:14 / 15C489 – Organizational Systems and Quality LeadershipCourse of StudyAccessibility PolicyStudent Support WGU values your input! Please submit any feedback you have using the following form:Course Feedback Access the WGU Library 24 hours a day, 7 days a week:WGU Library Visit the Student Success Center to access a variety of topics that will help you succeed at WGU:Student Success Center Contact the WGU Writing Center for help with any part of the writing or revision process:WGU Writing CenterPowered by TCPDF (www.tcpdf.org)15 / 15