Organizational Foundations

NURS – 6053N: Interprof Org & Sys Leadership

DISCUSSION #1

Organizational Foundations

As you strive to grow in your leadership skills and abilities, you will find that the context in which you work influences your motivation and areas of focus. In a similar vein, your commitment to developing professionally can contribute toward organizational effectiveness.

To that end, it is critical to recognize the importance of organizational culture and climate. In particular, through this week’s Learning Resources, you may consider several questions: How do an organization’s mission, vision, and values relate to its culture? What is the difference between culture and climate? Moreover, how are culture and climate manifested within the organization?

For this Discussion, you explore the culture and climate of your current organization or one with which you are familiar. You also consider decisions and day-to-day practices and the way they relate to the organization’s mission, vision, and values.

 

To prepare:

· Review the information related to planning and decision making in health care organizations presented in the textbook, Leadership Roles and Management Functions in Nursing: Theory and Application. Consider how planning and decision making relate to an organization’s mission, vision, and values, as well as its culture and its climate.

· Familiarize yourself with the mission, vision, and values of your organization or one with which you are familiar. Consider how the statements and actions of leaders and others within the organization support or demonstrate the organizational mission, vision, and values. In addition, note any apparent discrepancies between word and deed. Think about how this translates into expectations for direct service providers. Note any data or artifacts that seem to indicate whether behaviors within the organization are congruent with its mission, vision, and values.

· Begin to examine and reflect on the culture and climate of the organization. How do culture and climate differ?

· Why is it important for you, as a master’s-prepared nurse leader, to be cognizant of these matters?

 

Post a description of your selected organization’s mission, vision, and values. Describe relevant data, or artifacts, words, and actions of leaders and others in the organization that support, or perhaps appear to contradict the organization’s mission, vision, and values statement. In addition, discuss the organization’s culture and its climate, differentiating between the two. Explain why examining these matters is significant to your role as a nurse leader.

 

Learning Resources

Required Readings

Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in nursing: Theory and application (9th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.

· Chapter 1, “Decision Making, Problem Solving, Critical Thinking, and Clinical Reasoning: Requisites for Successful Leadership and Management”

 

Chapter 1 provides information relevant to this week’s Discussion and serves as a foundation for topics explored in future weeks of the course. The authors note that decision making, problem solving, critical thinking, and critical reasoning are integral to both leadership and management and beneficial as one examines leadership and management issues. As you read this chapter, focus primarily on the “Decision Making in Organizations” section.

 

· Chapter 7, “Organizational Planning”

 

This chapter introduces planning and highlights some of the trends that are likely to impact health care organizations now and in the future. It also addresses vision and mission statements, which are essential for guiding planning and decision making in health care settings.

 

· Chapter 12, “Organizational Structure”

 

This chapter addresses organizational culture.

 

Business Dictionary.com. (2013) Organizational culture: Definition. Retrieved from http://www.businessdictionary.com/definition/organizational-culture.html

 

Nelson, W. A., & Gardent, P. B. (2011). Organizational values statements. Healthcare Executive, 26(2), 56–59.

Retrieved from the Walden Library databases.

 

This article focuses on the impact that organizational values statements have on an organization’s mission. For employees to follow value statements, leaders must effectively model those values day in and day out.

Plath, D. (2013). Organizational processes supporting evidence-based practice. Administration in Social Work, 37(2), 171–188. doi:10.1080/03643107.2012.672946

Retrieved from the Walden Library databases.

Rai, G. S. (2013). Job satisfaction among long-term care staff: Bureaucracy isn’t always bad. Administration in Social Work37(1), 90–99. doi:10.1080/03643107.2012.657750

Retrieved from the Walden Library databases.

 

Watkins, M. (2013, May). What is organizational culture? Retrieved from https://hbr.org/2013/05/what-is-organizational-culture

 

This site offers several descriptions of organizational culture. These perspectives provide the kind of holistic, nuanced view of organizational culture that is needed by leaders in order to truly understand their organizations—and to have any hope of changing them for the better.

 

Online Assessments

Note:  Results from the following assessment are required for the course.

 

Keirsey Temperament Sorter (KTS-II). (n.d.). Retrieved from http://www.keirsey.com/

 

Please complete the online assessment and receive a free mini report. Additionally, more extensive reports are available for purchase and are optional. You should complete the Keirsey Temperament Sorter assessment early in the course so you will be prepared to discuss the results in Week 9.

 

Required Media

 

Laureate Education (Producer). (2012e). Foundations of an organization and organizational assessment. Baltimore, MD: Author.

 

In this week’s media presentation, experts from a diverse group of health care organizations share insights on how an organization’s mission, vision, and values influence its daily practices.

 

Laureate Education (Producer). (2012c). Factors that influence organizational cultures: Coastal Medical Associates, Salisbury, MA. Baltimore, MD: Author.

Laureate Education (Producer). (2012d). Factors that influence organizational cultures: Huntington Hospital, Pasadena, CA. Baltimore, MD: Author.

Optional Resources

You may find the following online assessments useful as you proceed through the course:

 

Appraisal 360. (n.d.). Retrieved from http://www.appraisal360.co.uk/

 

HumanMetrics. (n.d.). Jung Typology Test. Retrieved from http://www.humanmetrics.com/cgi-win/jtypes2.asp

 

Leadership-Tools.com. (2012). 360 degree feedback leadership tool. Retrieved from http://www.leadership-tools.com/360-degree-feedback-leadership.html

 

Union Rescue Mission. (Executive Producer). (2012). Stories from Skid Row [Video file]. Retrieved from http://urm.org/solution/stories-from-skid-row/

 

DISCUSSION # 2

Transitioning From Closed to Open Systems

How do effective nurse leaders and others approach problem solving and decision making in organizations? As suggested in this week’s Learning Resources, systems theory provides a valuable way to assess situations and prepare to address problems.

For this week’s Discussion, you identify an issue or process that could be improved and apply knowledge and strategies related to systems theory.

 

To prepare:

· Review the information presented in this week’s Learning Resources on systems theory and the difference between open and closed systems.

· Reflect on the practices and processes with which you are familiar in your organization. Identify one problematic issue or process that could be improved.

· Consider the problem from a closed-system perspective. Then think about how the issue or process you selected could be addressed by viewing it from an open-system perspective. How would the transition from a closed- to an open-system view help you and others to address the problem and improve outcomes?

 

Post a description of the problem that you identified in your selected organization. Explain the problem from a closed-system perspective. Then, describe how the problem could be addressed by viewing it from an open-system perspective, and explain how this modification would help you and others improve health care outcomes.

 

Learning Resources

Required Readings

Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in nursing: Theory and application (9th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.

· Review Chapter 7, “Organizational Planning”

 

See especially Figure 7.1.

 

· Chapter 8, “Planned Change”

 

· Organizational Change Associated With Nonlinear Dynamics

 

Read this section of Chapter 8 on planned change. Consider the role of leaders in effectively managing planned change.

 

· Chapter 12, “Organizational Structure”

 

· “Organizational Culture”

 

There are many structures organizations take, and these structures influence how the organization functions. This chapter discusses many different organizational structures and provides insights into how these structures influence the change process, as well as leadership and management.

 

Johnson, J. K., Miller, S. H., & Horowitz, S. D. (2008). Systems-based practice: Improving the safety and quality of patient care by recognizing and improving the systems in which we work. Retrieved from http://www.ahrq.gov/downloads/pub/advances2/vol2/Advances-Johnson_90.pdf

 

This article addresses the importance of systems-based practice (SBP) in health care workplaces. The authors state that SBP knowledge is one of six core competencies that physicians have to know in order to provide safe and proper care for their patients.

 

Manley, K., O’Keefe, H., Jackson, C., Pearce, J., & Smith, S. (2014). A shared purpose framework to deliver person-centred, safe and effective care: Organisational transformation using practice development methodology. FoNS 2014 International Practice Development Journal 4-(1).

Retrieved from the Walden Library databases.

Meyer, R. M., & O’Brien-Pallas, L. L. (2010). Nursing services delivery theory: An open system approach. Journal of Advanced Nursing, 66(12), 2828–2838.

Retrieved from the Walden Library databases.

 

In this article, the authors examine the effects of nursing services delivery theory in large-scale organizations. Among other benefits, this theory supports multilevel phenomena and cross-level studies, and it can guide future research and the management of nursing services.

Optional Resources

 

Glennister, D. (2011, July). Towards a general systems theory of nursing: A literature review. Paper presented at the 55th Annual Meeting of the International Society for the System Sciences, Hull, United Kingdom. Retrieved from http://journals.isss.org/index.php/proceedings55th/article/viewFile/1717/569

 

Hayajneh, Y. (2007). Management for health care professionals series: Systems & systems theory. Retrieved from http://www.hayajneh.org/a/readings/Systems-Theory.pdf

 

 

DISCUSSION # 3

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

 

Learning Resources

 

Required Readings

Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in nursing: Theory and application (9th 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. & 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, 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 Nursing11(4), 219–226. doi:10.1111/wvn.12044

Retrieved from the Walden Library databases.

Required Media

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

 

DISCUSSION # 4

Critiquing a Change Effort

As a nurse leader, you need to have the skills and knowledge to collaborate and communicate with those who plan for and manage change. This capacity is valuable in any health care setting and for many different types of change. Furthermore, it is essential to be able to evaluate a change effort and determine if it is promoting improved outcomes and making a positive difference within the department or unit, or for the organization as a whole.

To prepare:

· Review Chapters 7 and 8 in the course text. Focus on the strategies for planning and implementing change in an organization, as well as the roles of nurses, managers, and other health care professionals throughout this process.

· Reflect on a specific change that has recently occurred in your organization or one in which you have worked previously. What was the catalyst or purpose of the change?

· How did the change affect your job and responsibilities?

· Consider the results of the change and whether or not the intended outcomes have been achieved.

· Was the change managed skillfully? Why or why not? How might the process have been improved?

By Day 3

Post a summary of a specific change within an organization and describe the impact of this change on your role and responsibilities. Explain the rationale for the change, and whether or not the intended outcomes have been met. Assess the management of the change, and propose suggestions for how the process could have been improved.

 

Learning Resources

 

Required Readings

Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in nursing: Theory and application (9th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.

· Review Chapter 7, “Strategic and Operational Planning”

· Chapter 8, “Planned Change”

 

This chapter explores methods for facilitating change and the theoretical underpinnings of implementing effective change

McAlearney, A., Terris, D., Hardacre, J., Spurgeon, P. Brown, C.,  Baumgart, A.,  Nyström, M. (2014). Organizational coherence in health care organizations: Conceptual guidance to facilitate quality improvement and organizational change. Quality Management in Health Care, 23(4), 254–267 doi: 10.1097/QMH.0b013e31828bc37d

 

An international group of investigators explored the issues of organizational culture and Quality Improvement (QI) in different health care contexts and settings. The aim of the research was to examine if a core set of organizational cultural attributes are associated with successful QI systems.

Mitchell, G. (2013). Selecting the best theory to implement planned change. Nursing Management – UK20(1), 32–37. doi: 10.7748/nm2013.04.20.1.32.e1013

Retrieved from the Walden Library databases.

Shirey, M. R. (2013). Lewin’s Theory of Planned Change as a strategic resource. The Journal of Nursing Administration43(2), 69–72. doi:10.1097/NNA.0b013e31827f20a9

Retrieved from the Walden Library databases.

Required Media

Laureate Education (Producer). (2012g). Organizational dynamics: Planned change and project planning. Baltimore, MD: Author.

Optional Resources

Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in nursing: Theory and application (9th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.

· Chapter 9, “Time Management”

Batras, D., Duff, C., & Smith, B. J. (2014). Organizational change theory: implications for health promotion practice. Health Promotion International, Retrieved from MEDLINE with Full Text, EBSCOhost

 

This article reviews select organizational change models to identify the most pertinent insights for health promotion practitioners.

 

 

 

DISCUSSION # 5

Groups

The dynamic and increasingly complex world of health care often requires nurses to work collaboratively on interprofessional teams. In the group environment, individuals with unique skills and expertise come together to focus on a common goal; however, groups must become cohesive before they can become effective.

Your experiences working with groups—whether you perceive them as positive, negative, or neutral—can be used to facilitate insight and development. Health care, with its focus on interprofessional teamwork and collaboration, offers ample opportunities and an imperative for continuous learning.

For this Discussion, you focus on strategies for facilitating the group process.

 

To prepare:

· Review the information in this week’s Learning Resources regarding the stages of group formation, problematic roles individuals play in groups, and strategies for facilitating and maintaining positive group collaboration. In particular, review Learning Exercise 19.14 of the course text.

· Reflect on various groups with which you have been or are currently involved. Select one specific group to analyze for the purposes of this Discussion. Identify the purpose or task that the group is or was meant to perform.

· Consider the four stages of group formation (forming, storming, norming, and performing). How would you describe the progression between stages? Is there a stage in which you believe your group is or was “stuck”?

· Consider the task or group-building role you normally play in a group setting. How could you apply the information from the Learning Resources to improve your group participation and facilitation, as well as the functioning of the group as a whole?

· In addition, think about which individuals within your group (including yourself) may fall into problematic roles such as the Dominator, the Aggressor, or the Blocker. How have you and your group members addressed the enactment of these roles and its impact on interactions? With information from the Learning Resources in mind, what strategies would you apply now or going forward?

 

Post a description of a group with which you have been or are currently involved. Assess where the group is in terms of the four stages of group formation. If you are reflecting on a past experience, explain if your group moved through all four stages. Describe the task or group-building role you typically play, or played, in this group. Then, explain what strategies you, as a leader, can apply to better facilitate the group process and address any problematic individual roles in the group.

Learning Resources

Required Readings

Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in nursing: Theory and application (9th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.

· Chapter 19 “Organizational, Interpersonal, and Group Communication”

 

Chapter 19 covers many aspects of the communication process, including group communication. As you read this chapter, focus on the stages of group development (forming, storming, norming, performing) and group dynamics (group task roles, group building and maintenance roles, problematic roles). Consider how you can apply these concepts as you engage in group work.

Adams, S. L., & Anantatmula, V. (2010). Social and behavioral influences on team process. Project Management Journal, 41(4), 89–98.

Retrieved from the Walden Library databases.

 

In this article, the authors report on the effects of individual behaviors on project teams and provide a model that identifies the progress of social and behavioral development. For each stage, the authors provide recommendations for managing team members.

Chun, J. S., & Choi, J. N. (2014). Members’ needs, intragroup conflict, and group performance. The Journal Of Applied Psychology99(3), 437–450. doi:10.1037/a0036363

 

This study theorizes and empirically investigates the relationships among the psychological needs of group members, intragroup conflict, and group performance.

Haynes, J., & Strickler, J. (2014). TeamSTEPPS makes strides for better communication. Nursing,44(1), 62–63. doi:10.1097/01.NURSE.0000438725.66087.89

 

Teamwork and communication are the focus of this article and include the use of the TeamStepps model for Quality Improvement.

Hogg, M. A., Van Knippenberg, D., & Rast, D. E., III. (2012). Intergroup leadership in organizations: Leading across group and organizational boundaries. Academy of Management Review, 37(2), 232–255.

Retrieved from the Walden Library databases.

 

The authors of this article introduce a theory on intergroup leadership that is based on social theory and intergroup relations. This theory purports that intergroup performance relies on a leader’s capacity to create intergroup relational identities.

Kaufman, B. (2012). Anatomy of dysfunctional working relationships. Business Strategy Series, 13(2), 102–106.

Retrieved from the Walden Library databases.

 

Kaufman examines the impact of dysfunctional working relationships in an organization. She provides managers with tips that will allow them to identify early warning signs of dysfunctional behavior and to minimize its effects in the workplace.

 

Mind Tools. (2012). Forming, storming, norming and performing: Helping new teams perform effectively, quickly. Retrieved from http://www.mindtools.com/pages/article/newLDR_86.htm

 

This web article discusses stages of team development and provides strategies for moving through the early stages effectively.

 

Mind Tools. (2009). Team charters. Retrieved from http://www.mindtools.com/pages/article/newTMM_95.htm

 

This web page features helpful information about team charters. Before you begin work on the Week 7 Assignment, you may find it helpful to create a charter that can guide your group’s work together.

 

Ortega, A., Sánchez-Manzanares, M., Gil, F., & Rico, R. (2013). Enhancing team learning in nursing teams through beliefs about interpersonal context. Journal Of Advanced Nursing69(1), 102–111. doi:10.1111/j.1365-2648.2012.05996.x

 

This article examines the relationship between team-level learning and performance in nursing teams, and the role of beliefs about the interpersonal context in this relationship.

 

Table Group. (n.d.). Retrieved July 24, 2012, from http://www.tablegroup.com/

 

Patrick Lencioni is recognized worldwide for his work on teams. Under the Patrick Lencioni link, download and read articles related to addressing team dysfunctions.

 

Optional Resources

Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in nursing: Theory and application (9th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.

· Chapter 16, “Socializing and Educating Staff for Team Building in a Learning Organization”

 

DISCUSSION # 6

Power Dynamics

Bring to mind a nurse whose words, behaviors, or reputation convey power. What is it about this individual that suggests power? How does your perception of this person relate to your view of yourself as a nurse leader and the image you associate with nursing?

Learning Resources

 

Required Readings

Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in nursing: Theory and application (9th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.

· Chapter 13, “Organizational, Political, and Personal Power”

 

Chapter 13 delves into different types of power. As you read, consider how you see power demonstrated within your own organization.

Leach, L. S., & McFarland, P. (2014). Assessing the professional development needs of experienced nurse executive leaders. Journal of Nursing Administration44(1), 51–62.

Retrieved from the Walden Library databases.

 

McMurry, T. B. (2011). The image of male nurses and nursing leadership mobility. Nursing Forum, 46(1), 22–28.

 

This article discusses the underrepresentation of males in nursing and the advantages and difficulties faced by men in the nursing profession.

 

Rao, A. (2012). The contemporary construction of nurse empowerment. Journal of Nursing Scholarship, 44(4), 396–402.

Retrieved from the Walden Library databases.

Spence Laschinger, H. K., & Fida, R. (2014). New nurses burnout and workplace wellbeing: The influence of authentic leadership and psychological capital. Burnout Research. 1(1), 19–28.

Retrieved from the Walden Library databases.

Tost, L. P. (2015). When, why, and how do powerholders “feel the power”? Examining the links between structural and psychological power and reviving the connection between power and responsibility. Research in organizational behavior, 35, 29–56.

Retrieved from the Walden Library databases.

Required Media

Laureate Education (Producer). (2012h). Personal power plan. Baltimore, MD: Author.

 

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