leadership
- Define communication and discuss its importance in healthcare
- Name three variables that can affect organizational communication—assign their impact on outcomes
- What are some channels of communication in an organization? Why is this important to know?
- What are the various communication methods? Is one better than another?
- What are the elements of non-verbal communication? Which of these are you aware of and use in your relationships?
- Name 4 types of communication—strengths and weaknesses of each?
- SBAR—What does this mnemonic stand for?
- What are the main points of importance about the ANA/NCSBN Principles for Social Media/Social Networking use?
- Name one way you will adapt your current usage of social media as you become a professional nurse
- What does HIPAA stand for? What is its importance in healthcare?
- Name 5 ways a nurse can violate HIPAA
- What is the EHR—and what are risks nurses must be aware of?
- What are the 4/5 phases of group formation?
- Name and define 3 group building and maintenance roles in groups
- Define the generational diversity that is present in the nursing profession
Define Case Management Nursing
- What are critical pathways and multi-disciplinary action plan (MAP)—how do they support patient care?
- What are the main principles governing the work of case managers?
- What are some of the main principles guiding a Magnet-designated facility?
- How do you relate the 14 forces of magnetism to excellence in nursing practice?
- Define shared governance and its relationship to nursing practice
- Define the term organizational culture—what might it contain that would contribute to excellent patient care?
Chapter 19
Organizational,
Interpersonal,
and Group Communication
in Team Building
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Learning Objectives
1. Describe the relationship between communication and team building (Text p 518)
2. Describe strategies managers can take to increase the likelihood of clear and complete organizational communication (Text 498-500)
3. Choose appropriate communication modes for specific situations and messages (Text p 500)
4. Differentiate among assertive, passive, aggressive and passive-aggressive communication (Text p 504)
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Learning Objectives
5. Recognize I-SBAR, SBAR, I-PASS as structured, orderly approaches in providing accurate, relevant information in emergent patient situations as well as routine handoffs (ATI p 26) (Text 505-506)
6. Recognize the need for confidentiality in sensitive interpersonal, group, or organizational communication (Text 513-515)
7. Describe the opportunities as well as the challenges new technologies pose for communication in contemporary organizations (Text 510-12)
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Learning Objectives
8. Recognize the potential benefits of social media as a communication tool as well as the potential risks and identify principles for social networking use that minimizes those risks (Text 510-12)
9. Assess accurately the stages of group formation (forming, storming, norming and performing (ATI p 24) (Text p 516)
* Generational Work Groups (ATI p 24) (Text 453-54)
* Consultations/Referrals/Transfers and Discharge Planning (ATI p 26-27)
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Learning Objectives
* Confidentiality and Information Security (ATI p 40) (Text p 513-515)
* Information Security (ATI p 40) (Text 510-512)
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Communication #1
Communication impacts all management activities and cuts across all phases of the management process.
The ability to communicate effectively often determines success as a leader-manager.
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Communication #2
Communication begins the moment that two or more people become aware of each other.
Communication is perhaps the most critical leadership skill.
Organizational communication is a high-level management function.
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The Communication Process
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Internal and External Climate in Communication
Internal climate
Includes internal factors such as the values, feelings, temperament, and stress levels of the sender and the receiver
External climate
Includes external factors such as the weather, temperature, timing, status, power, authority, and the organizational climate itself
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Variables Affecting Organizational
Communication #1
Number of levels that need to communicate
Gender
Power and status
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Variables Affecting Organizational
Communication #2
Differences in gender, power, and status can significantly affect the types and quality of organizational and unit-level communication.
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Organizational Communication Strategies
Communication must be clear, simple, and precise.
Senders should seek feedback whether communication is received.
Multiple communication methods should be used.
Unnecessary information should not be disclosed.
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Channels of Communication #1
Upward
From subordinate to superior
Downward
From superior to subordinate
Horizontal
From peer to peer
Diagonal
Between individuals at differing hierarchy levels and job classifications
Grapevine
Informal, haphazard, and random, usually involving small groups
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Channels of Communication #2
The most informal communication network is often called the grapevine. Grapevine communication flows quickly and haphazardly among people at all hierarchical levels and usually involves three or four people at a time. Senders have little accountability for the message, and often, the message becomes distorted as it speeds along.
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Communication Modes #1
Written
Face-to-face
Telephone
Nonverbal
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Communication Modes #2
The clarity of a message is significantly affected by the mode of communication used. In general, the more direct the communication, the greater the probability of clear communication. The more people involved in filtering the communication, the greater the chance of distortion.
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Elements of Nonverbal Communication
Space
Environment
Appearance
Eye contact
Posture
Facial expression and timing
Vocal expression
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Types of Communication
Passive
Aggressive
Indirectly aggressive (passive–aggressive)
Assertive
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Misconceptions and Myths About Assertiveness
All behavior is either assertive or passive.
Being assertive will:
Increase the odds of getting what you want
Increase your self esteem
To be assertive is to be aggressive.
Assertiveness is unfeminine.
Assertive communication is rude or insensitive.
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When Under Attack by an Aggressive Person
Reflect.
Repeat the assertive message.
Point out the implicit assumptions.
Restate the message using assertive language.
Question.
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SBAR as a Handoff Communication Tool
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GRRRR as a Listening Tool #1
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GRRRR as a Listening Tool #2
Most people hear or retain only a small amount of the information given to them.
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Components of a Business Memo
Header
Opening, context, and task
Summary, discussion segment
Closing segment, necessary attachments
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ANA/NCSBN Principles for Social Networking #1
Nurses must not transmit or place online individually identifiable patient information.
Nurses must observe ethically prescribed professional patient–nurse boundaries.
Nurses should understand that patients, colleagues, institutions, and employers may view postings.
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ANA/NCSBN Principles for Social Networking #2
Nurses should take advantage of privacy settings and seek to separate personal and professional information online.
Nurses should bring content that could harm a patient’s privacy, rights, or welfare to the attention of appropriate authorities.
Nurses should participate in developing institutional policies governing online conduct.
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1996 Health Insurance Portability and Accountability Act (HIPAA)
Called for protection and privacy of medical information, including any information about a patient, whether oral or recorded in any form or medium, that is created or received by a health-care provider, health plan, public health authority, employer, life insurer, school or university, or health clearing house
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The Electronic Health Record (EHR) #1
A longitudinal electronic record of patient health information produced by encounters in one or more care settings
Included in this information are patient demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data, and radiology reports
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The Electronic Health Record (EHR) #2
Rapidly flourishing communication technologies have great potential to increase the efficiency and effectiveness of organizational communication. They also, however, pose increasing challenges to patient confidentiality.
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Stages of Group Formation
Forming
Storming
Norming
Performing
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Group Roles #1
Initiator
Information seeker
Information giver
Opinion seeker
Elaborator
Coordinator
Orienter
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Group Roles #2
Evaluator
Energizer
Procedural technician
Recorder
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Group Building and Maintenance Roles
Encourager
Harmonizer
Compromiser
Gatekeeper
Standard setter
Group commentator
Follower
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Roles Commonly Assumed by Group Members #1
Aggressor
Blocker
Recognition seeker
Self-confessor
Playboy
Dominator
Help seeker
Special interest pleader
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Roles Commonly Assumed by Group Members #2
Communication and team building are intertwined because team-building activities encourage trust, cooperation, and communication within a group and improving communication enhances how workers interact with one another.
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Chapter X
The topics that don’t belong to any assigned chapters…but are important to ATI/NCLEX
Case Management nursing
Collaborative process that assesses, plans, implements, coordinates, monitors, and evaluates options and services to meet an individual’s health needs through communication and available resources to promote quality, cost-effective outcomes
Coordinates care through an episode of illness
The focus is on individual clients, not populations of clients.
Managing Care with Case Management #1
Case managers often manage care using critical pathways and multidisciplinary action plans (MAPs) to plan patient care.
The care MAP is a combination of a critical pathway and a nursing care plan, which indicates times when nursing interventions should occur.
All health-care providers follow the care MAP to facilitate expected outcomes.
If a patient deviates from the normal plan, a variance is indicated.
PRINCIPLES OF CASE MANAGEMENT (ATI CHAP 2, P25)
Case management focuses on managed care of the client through collaboration of the health care team in acute and post acute settings
The goal of case management is to avoid fragmentation of care and control cost
A case manager collaborates with the interprofessional team during the assessment of a client’s needs and subsequent care planning, and follows up by monitoring the achievement of desired client outcomes within established time parameters
A case manager can be a nurse, social worker, or other designated healthcare professional. A case manager’s role and knowledge expectations are extensive
Principles of case management continued
Therefore case managers are required to have advanced practice degrees or advanced training in this area.
Case manager nurses do not usually provide direct client care
Case managers usually oversee a caseload of clients who have similar disorders or treatment regimens
Case managers in the community coordinate resources and services for clients whose care is based in a residential setting
Principles of case management continued
A critical or clinical pathway or care map can be used to support the implementation of clinical guidelines and protocols. These tools are usually based on cost and length of stay parameters mandated by prospective payment systems such as Medicare or insurance companies
Nursing role in case management (ATI p 25)
Coordinating care, particularly for clients who have complex health care needs
01
Facilitating continuity of care
02
Improving efficiency of care and utilization of resources
03
Enhancing quality of care provided
04
Limiting unnecessary costs and lengthy stays
05
Advocating for the client and family
06
Magnet recognition program (ATI Chap 2, p 24) (Text 314-16)
Well-qualified nurse executives in a decentralized environment, with organizational structures that emphasize open, participatory management
Autonomous, self-managing, self-governing climates that allow nurses to fully practice their clinical expertise, flexible staffing, adequate staffing ratios, and clinical career opportunities
Characteristics of
magnet hospitals
A professional practice culture in all aspects of nursing care
Compliance with standards in the ANA’s Scope and Standards for Nurse Administrators
The 14 forces of magnetism for magnet hospital status # 1
Quality of nursing leadership
Organizational structure
Management style
Personnel policies and programs
Professional models of care
Quality of care
Quality improvement
the 14 forces of magnetism for magnet hospital status # 2
Consultation and resources
Autonomy
Community and the hospital
Nurses as teachers
Image of nursing
Interdisciplinary relationships
Professional development
Shared Governance
Nurses at every level play a role in the decisions that affect nursing activity throughout the system.
Nurse-managers move out of traditional industrial model roles into collegial models, becoming moderators of the service process.
Usually defined by a structure of rules or bylaws
Organizational culture
The values and behaviors that contribute to the unique social and psychological environment of an organization
A sum total of values, language, traditions, formal and informal communication networks, and the rituals of an organization
READ DISPLAY 12.3 (TEXT p 311):
“ASSESSING THE ORGANIZATIONAL CULTURE