Questions and Answers of Introduction To Healthcare Quality Management

Look at the 10 principles of servant leadership (Box 2.3). How do these principles fit within your approach to work? Do you employ any of them in your day‐to‐day activities?
Think about your personal values and take some time to make a list them. Are the things you listed similar to the values offered in Box 3.7?
If you can, approach a person who you feel is a clinical leader. Explain to them that you see them as a clinical leader and ask them how they feel. Were they shocked, surprised, delighted? How did
What are your experiences of leadership development from your undergraduate or formative healthcare education? Do you feel well prepared and instructed in leadership theories and techniques? Ask some
Draw a ‘mind map’ with the word ‘leadership’ in the centre. You could start the map here and build or add to it as you progress through the book or over the trajectory of your studies.
Who are your leaders? Who might you direct an alien or stranger to if they asked you to take them to your leader? Would these be the same people if you were asked to take them to your ‘clinical
Having considered these theories of leadership, do any of them feel as if they ‘fit’ the clinical environment you work within, in terms of explaining what you understand leadership to be about?
Using a general internet search engine, look for ‘leadership styles’. See what comes up. Identify any styles that you feel will help you and note down the positive and negative aspects of each,
Transformational leadership is associated with leaders who lead change as a definitive aspect of their role. Think about the characteristics of a transformational leader. Can you reflect on times
Authentic leadership, servant leadership, compassionate leadership and congruent leadership are all types of values‐based leadership theories (James et al. 2021). Read James’s article and think
Discuss your values list with a professional colleague. Find out if they have similar values, what their values are or how they might express them.
Reflect on the relationships you have had with a past or present ‘leader’. Think about the kind of working relationship you have had with them and what thought (if any) you have put into your
Undertake the Followership Style Questionnaire in this chapter. What are your thoughts about the result? Have you ever been taught about followership? Yes or No. Why do you think this is?
Does your organisation encourage the participation of followers? Do you feel that you have ‘power’ as a follower? If not, how could you use some of the change models offered in Chapter 7 to
Who would you identify as the most effective followers in your ward/clinic/team or clinical area? Are these the same people you might identify as leaders or potential leaders?
Think about your formative healthcare education. What did you learn about management? Was this adequate? Do you think that there are other matters or topics that health professionals should learn
Think about a leader (from your work, from history, politics, or any walk of life) whom you admire, look up to or have been inspired by. Write a short summary about what it is or was about them that
Are clinical leadership, management and profession-specific leadership different? Think for a moment about these three concepts and how they relate to your professional position. Is there something
In researching the difference between leadership and management in the health service, trying to undertake both roles (leadership and management in the one position) was found often to lead to
If culture is people focused, what impact do you think technology is having on our relationships and our organisational culture? Talk to some of your senior colleagues and ask them how much impact
Bradshaw (2016) wrote a very interesting article about the hidden presence of M. Simone Roach’s model of caring, which seems to have been the ‘unwritten’ precursor to the 6Cs. Bradshaw is of
Listen to the songs ‘The times they are a-changin’ by Bob Dylan (1967), ‘Changes’ (1971) by David Bowie and ‘Revolution’ by the Beatles (1968). Are the times always ‘a-changin’ or was
Draw up your own version of the FFA model. Think of a problem you want to address. It can be personal or work related. Begin by listing the driving then restraining forces that have an impact on the
Return to your mind map of the various changes you would like to make in your area of practice and apply the various models presented in this chapter to two of these proposed changes. Next, think
Identify five potential adverse incidents that could occur in your clinical area and develop strategies that you could implement to minimise the risk of the incident occurring. Share these with your
Reflect on the predominant leadership styles used in your clinical area. What impact do they have on the safety culture of the clinical area?
Undertake a small survey where you work. Ask a number of colleagues if they have ever made a mistake with a clinical decision. Do not focus on what they did wrong or he outcome, but ask about why
Access the internet and see if you can find references to the decision-making approaches detailed in this chapter. Once you have found the information, try the techniques out. Consider decisions you
Look at something as if you were a child: a policy, a relationship or a problem. Ask yourself ‘What does this look like to me?’ or ‘What does this make me think of?’ Try to consider the
How do you find time to focus, to be mindful, to be present and deal creatively with the problems you face? Try looking now at one problem. Write it down. Give some time to considering it. Focus on
Is failure an issue? What are the consequences of failure for you? For your clients? For your part in the health service? Clinical trials are often avoided by clients who may be afraid of becoming
Look for the Belbin Team Role questionnaire online (or go to Belbin’s original text, Belbin 1981) and complete the questionnaire. Assess what your team role is.
Watch the You Tube video on ‘Teaming’ here:How to turn a group of strangers into a team | Amy Edmondson – YouTube How do you think these strategies may be helpful for you as a leader?
Do teams from different professional disciplines work differently or are their teamworking principles the same? Does it matter?
Are you a leader within your team? If so, how do you use support and challenge to strengthen or achieve team cohesion?
Are there tasks that you could delegate to others? How do you go about it? Are people generally receptive to your requests, or do they respond with resentment? Why do you a think people respond the
When delegating to people from other cultures, it is important to consider how you communicate, interpersonal space, issues related to social organisation, time, environmental issues and biological
How easy or difficult do you find the act of delegation? Reflect on why you might feel this way. Is it about your clinical competence, confidence, authority or experiences with previous delegation
How was conflict resolved in your family when you were growing up? What lessons have you learnt about conflict resolution from your experiences with family, friends and co-workers?
When you have a conflict with someone, how do you prefer to handle it? What approaches to dealing with conflict are you less comfortable with or would rather not use?
Think of someone with whom you often find yourself in conflict. What is the behavioural style or conflict strategy that you often notice them using? How can understanding this help with the conflict
Answer the following questions – and be honest with yourself. Take 15 minutes to completethis, then discuss your answers with another person.● Describe your level of autonomy now in the
Visual motivation: Select a picture or photograph (magazines can be useful or your own photo collection) and create an inspirational statement to accompany your image. If the result really resonates
Think of a time you have failed. How did you respond? Did you give up? Why? What might have happened if you had regrouped and tried again or tried a new approach to the issue? Can you see that
Are you able to define EBP? Try to put it in your own words. Imagine that you are explaining it to a neophyte health professional in your area. What will you say?
Can you name three areas of your practice that are supported by EBP? Can you name any areas that are not?
What might be the barriers to the successful implementation of EBP in your clinical area or area of professional practice? Are the barriers and issues likely to be resolved? If they have been, how
Decide on two methods of reflection, such as writing a journal or verbalising your thoughts with a reflective companion and compare them to assess what the more effective reflective method is for you.
Watch the animated film Inside Out. What does it say about emotional intelligence and about the emotional internal dialogue that might be going on inside all of us?
Think about a recent conversation with a friend or work colleague. Did you practice emotional intelligence? Do you think they left the conversation feeling enhanced or diminished by the dialogue? How
Now that you have an idea of what constitutes project management, imagine you have a birthday party to deliver. Undertake the following task:● Plan a birthday party: Budget $2000.● Customer
Does managing a project mean taking total control? What are the other skills (some are outlined in this book) that you think might be used to support the job of managing a project successfully?
Can clinical leaders really change the quality on offer to clients in the health service? Have you seen it happen? Look around your clinical area. What can you see in practice that has come about
There is a common perception that many men in nursing (or healthcare in general) are focused on seeking a career in management. Do male health professionals have any advantages over their female
Do generational differences exist in your workplace? Talk to your colleagues about this question. Are the main differences generational or are there other, less ‘global’ issues that cause
Consider two types of leadership: transformational leadership and congruent leadership. What sources of power would you identify as being associated with the theories behind them, and why?
What positive outcomes might be achieved for your future colleagues if, in the course of your work, you use your power and authority constructively?
Consider your professional role in social justice. How can you apply these principles to current challenges in healthcare?
Do you think that nurses or other health professionals have inherited the values of the medical profession, and have they evolved? Discuss this question with your colleagues. What are their views?
In your experience, have you ever encountered times when you have felt oppressed or been exposed to horizontal violence? Think about when this occurred and why it might have happened. How did you
Consider the characteristics of leaders of oppressed groups. Do any of these put you in mind of people you have worked for or with? In what way?
How do historical stereotypes impinge on our profession’s ability to influence the direction and quality of care and the health service?
If nurses and some other clinically focused health professionals are oppressed, then taking steps to be liberated is vital. How can you take steps to liberate yourself (if you see the need) or to
Consider the case study and the emotions expressed.Reflect on how you may have felt in this situation. Have you experienced something similar during the pandemic or in any other challenging
Do you think that nurses or other health professionals have experienced moral distress during the pandemic? Discuss this question with your colleagues. What are their views?
In your experience, have you ever encountered times when you have felt unable to express your emotional reaction in a crisis? How did this impact your approach to your work environment?
Consider the characteristics of leaders who demonstrate compassion or a values-based approach. Have you worked with a compassionate or values-focused leader? How did this make you feel?
Do you think we look after our own and others’ well-being at work? What can we do to improve this?
How can we best learn from this crisis? How can we best share experiences of both positive and negative leadership during this time?
In your opinion, which companies provide superior customer service? Which companies provide average or mediocre customer service? Name the factors most important to you when judging the quality of a
Think about your most recent healthcare encounter. What aspects of the care or service were you pleased with? What could have been done better?
How does the reliability of healthcare services affect the quality of care you receive?What type of healthcare service do you find to be the least reliable in delivering a quality product? What type
Which National Quality Strategy priority is most important to you as a healthcare consumer, and why? Which priority do you believe is most important to providers, and why? Which priority do you
Describe how you use the cycle of measurement, assessment, and improvement (see exhibit 2.1) to evaluate and make changes in your personal life. Yes Measurement How are we doing? Assessment Are we
How do quality practices that originated in the manufacturing industry differ from the traditional quality practices of healthcare organizations?
What could a healthcare supervisor or manager do to show support for each core value of the Baldrige Criteria ?
Consider the healthcare encounter you described in chapter 1 (see “For Discussion” question 2). If wasteful practices had been eliminated or steps in the process had been standardized, would you
For any healthcare activity, four performance factors can be measured: structure, process, outcome, and patient experience. Identify one measure from each of these categories that could be used to
Describe, in fundamental terms, each measure you selected to evaluate the surgery center’s admission process. What are the numerator and denominator? If the measure does not require a numerator and
Suppose the manager of the surgery center’s registration area wants to gather data to report performance results for the measures you have chosen. What data sources could be used to gather
Identify one structure measure, one process measure, one outcome measure, and one customer experience measure that could be used to evaluate a manager’s process for hiring a new employee. The
Search the CMS Measures Inventory Tool:https://cmit.cms.gov/CMIT_public/ListMeasures. Identify five evidence-based performance measures related to prescribing the correct medications for patients.
In your opinion, what is the greatest barrier to ensuring the quality of data used for performance measurement purposes? Support your opinion with literature references.
The Centers for Medicare & Medicaid Services (CMS) care compare website (www.medicare.gov/care-compare/) allows you to compare performance at nursing homes throughout the United States. Go to this
The CMS care compare website (www.medicare.gov/care-compare/) allows you to compare performance at hospitals throughout the United States. Go to this site and review the data for each hospital
The Joint Commission Quality Check website (www.qualitycheck.org) provides performance ratings for accredited organizations. Go to this site and look up hospitals in your area. What is different
An independent survey company provides your department with customer satisfaction data each week. The goal set by your leadership is to have 80 percent highly satisfied, and when the weekly score is
Many examples of improvement projects conducted by healthcare organizations can be found in the literature and on the Internet. Find an example of three different types of projects (PDSA, RCI, IHI
Select the improvement model that would work best for the following performance problems. Explain your choices.• More than 25 percent of the insurance claims submitted by a clinic are rejected
What improvement tool would you use to identify all possible reasons for the increase in complaints about the HIM department?Imagine you are the supervisor of the health information management (HIM)
What improvement tool would you use to gather data to confirm the reasons for the complaints about the HIM department?Imagine you are the supervisor of the health information management (HIM)
You hypothesize that complaints spike on certain days of the week. What improvement tool would you use to analyze this theory?Imagine you are the supervisor of the health information management (HIM)
The HIM staff tally information about the causes of complaints. What improvement tool would you use to prioritize the problems?Imagine you are the supervisor of the health information management
What improvement tool would you use to define the current process for retrieving patient records?Imagine you are the supervisor of the health information management (HIM) department in a large
You believe that cooperation between the clinic receptionists and HIM staff would improve if phone responsibilities were more clearly defined. To whom would you assign the task of defining roles and
After redesigning the process for investigating insurance denials, you want to monitor the effectiveness of your actions. What improvement tool would you use to determine whether the number of
Of the ground rules listed in critical concept 7.1, which three are most important for a team to adopt, and why? When choosing the rules, consider your past experiences working with a team or a
Use the template in exhibit 7.2 to create a charter for an improvement project involving a healthcare process that you are familiar with. Complete as many sections of the charter as possible. Problem
If you were the team leader of the group described in the following case study, how would you refocus and remotivate the team toward achieving the improvement goal?When members were recruited for the
Go through the steps of an FMEA project for the process of taking a bath, shown in the following flowchart. Use a worksheet like the one in exhibit 8.9 to document your ideas.When completing the

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