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LEADERSHIP for quality and safety

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1 LEADERSHIP for quality and safety
NURSING 406 Frostburg State University Leslie Lister 2012

2 Creative Implementation of Leadership
The following presentation is an insight to my leadership abilities

3 Humanmetrics Jung Typology Test
My Personality Humanmetrics Jung Typology Test ENFJ Extravert 89% iNtuitive 75% iNtuitive Feeling 12% Judging 67% My focus is expansive and I have the ability to see the big picture. I have an amazing ability to juggle a large number of responsibilities and projects simultaneously. I am very organized and decisive. I am more resilient than most of my co-workers. *Likewise, as a staff educator I have presented almost all of my learning materials through the format of PowerPoint's, which is why I choose to do it this way for this class*

4 My Leadership Characteristics
Passion for Nursing Beliefs about management Expectations of others Self-confidence Self-Efficacy Possesses Emotional Intelligence Communicates well Empowers staff Anticipates problems Use positive reinforcement Listens more than I speak Continues education Thinks outside the box

5 My Current Leadership role:
Nurse Manager of Endoscopy Center Newly obtained role as of November 5, 2012

6 My Facility Maryland Diagnostic & Therapeutic Endo Center www. mdtecmd
My Facility Maryland Diagnostic & Therapeutic Endo Center Gastroenterology Endoscopy Suite Total of 3 procedure rooms Combination of 7 admitting/recovery beds Staffing has been Self-Team Managed for the past 5 years Only employs 2 full-time nurses Total of 4 part-time nurses share other full-time nursing slots Uses per diem nurses as needed Procedure rooms are run by 2 full-time and 1 part-time GI Tech Has 1 fabulous sterile processing tech Averages between patients/procedures a day

7 “Leadership is the art of accomplishing more than the science of management says is possible.” -General Colin Powell

8 Legal Issues Faced As A Nurse Leader
1. Standard of Care: 2. Scope of Practice: 3. Liability: 4. Negligence: 5. Informed Consent: 6. Confidentiality: 7. Malpractice: This means as a Nurse Manager I must speak, write, and act legally, ethically & responsibly. All of my actions and the nurses under me must be carefully monitored to ensure and reduce potential liability. My clinical staff’s actions /words must not cause harm. I must ensure we all act reasonable & professional. All patients must fully understand a treatment & it benefits and risks before agreeing that it be done. As a Nurse Manager I must ensure that patients information is not being disclosed improperly. This occurs when the standard of care is breached. It is my job to do all that I can to prevent this.

9 My Responsibility Regarding Legal Issues:
Communication & Documentation Practicing Ethical Leadership Establishing an on-going relationship Knowing about current Legal trends Encouraging nurses to speak Up about errors Following the American Disabilities Act The Family Medical Leave Act

10 Ethical Issues Faced As A Nurse Leader
1. Nursing Ethics: 2. Beneficence: 3. Nonmaleficence: These are based on a set of values derived by the profession Doing good by caring for the patient Doing no harm to the patient Justice = being fair to the patient Autonomy = preserving the freedom of the client and the nurse Loyalty = keeping promises made to the patient Veracity = telling the patient the truth Confidentiality = not sharing what was told in private Life = treasuring the patient’s existence

11 10 Ethical Principles To Follow As A Leader
Frugality & therapeutic elegance: I recently did a Biohazard Waste Reduction Education which resulted in a 42% reduction of our biohazard waste costs. Clinical credibility through organizational competence: We just completed our yearly mandated clinical Skills Reviews and workstations. Every year, all employees must review required skills and pass tests on knowledge of our clinics standards of care. Providing Presence: I work alongside my employees every Monday and any other times that assistance is needed. I would never ask anything of my employees that I myself would not do. Representing ethical concerns: Monthly meetings are held to address employees concerns and ideas. All of these are taken very seriously. Loyalty: My clinic is my pride. Delegating ethically: Everyone has a job description and employees are only asked to do what is asked of them in this description. Responsible innovation: Change is brought about to ensure compliance, patient safety and employees well-being. Fiduciary accountability: We follow standards of care and only bill for appropriate procedures. Self-discipline: It is always wise to take a deep breath before answering any emotional question. Continuous learning: As shown by my current enrollment in college.

12 Cultural Development A key purpose of our practice development is to transform the culture of care so that it becomes and remains patient-centered, evidence-based and is continually effective in our every changing healthcare system We are a private practice and must hold ourselves to a higher standard to be able to attract potential patients/customers

13 Team Creation “Look for intelligence and judgment, and most critically, a capacity to anticipate, to see around corners. Also look for loyalty, integrity, a high energy drive, a balanced ego, and the drive to get things done.” -General Colin Powell

14 One Bad Apple Can Spoil The Bunch
Team Creation One Bad Apple Can Spoil The Bunch

15 Approaches To Team Building
Build a vision Establish shared goals & expectations Keep employees well-informed Promote a caring environment that’s conducive to teamwork Listen Teach supportive behavior Assess & build self-esteem in employees Encourage stability Set an example Accept Responsibility Share the spotlight Encourage & model positive interactions

16 Combination of my motivation factors:
My Coaching Skills EXPECTANCY THEORY: Combination of my motivation factors: I focus on the future of our clinic and of my employees careers I only promote optimism Constructive criticism is still criticism and I believe should be avoided Valence: I educate the staff on what’s in it for them Instrumentality: I educate how our actions together as a team will reach our desired outcome Expectancy: I believe and lead my staff to believe in our success

17 My Leadership Style I am influenced by the following leadership styles The first being The Human Relations Approach to Management. I focus on motivating my staff through teamwork, open communication, and innovation of ideas that fulfill our clinics and my employees goals. The second being Argyris’s Theory of Humanistic & Democratic Values. Increased output is seen if work is made to be exciting and challenging and all employees are treated equally as people.

18 We were recently surveyed by the AAAHC
Accreditation Association for Ambulatory Health Care This agency provides voluntary accreditation which measures the quality of our services and performances against nationally recognized standards

19 Ways I Prepared Our Center for Inspection
Educated staff on what being surveyed meant Educated staff on reasons why the survey was needed to be successful to the future of our clinic Reviewed all AAAHC/Medicare policy changes Reviewed all Nationally made changes to standards of care I went through our center inch by inch looking for imperfections When problems were found staff were educated on why the process needed to be changed and how to change it

20 After new processes were put into place, I rechecked on staff & procedures to make sure all was being carried out appropriately Staff were praised for doing things correctly Staff were encouraged to offer ideas Quality & Assurance projects were all finished Staff’s files were updated (if needed) Infection Control was preached over and over All of clinics policies were reviewed and signed off by staff All drugs were checked for expiration dates No congregated cardboard was any longer allowed to be in the clinical area

21 Contracted anesthesia service was re-educated on all safe needle and multi-dose medications protocols Staff was reminded that PPE Protocol was mandatory The entire center was cleaned from ceiling to floor All equipment was double checked to make sure it was in proper working order and up to proper standards All of our education, studies, and projects were placed in easy reading/review format for the surveyor

22 WE PASSED !!!

23 My Keys to Successful Team Work
My team understands our goals: Through meetings and daily interactions I provide clear direction to accomplish our vision and mission of our center I take reasonable risks: “You don’t know what you can get away with until you try.” -General Colin Powell

24 My Keys to Successful Team Work
Communication is open, honest & respectful: Monthly staff meetings encourage this, along with my open door policy My staff has a strong sense of belonging to the group: I provide a deep commitment to my staff’s group decisions and actions. I not only have loyalty to the clinic, but also to my staff

25 How I Promote Success In My Work Setting
I learn from people who are different from me I manage my time and priorities appropriately I constantly acquire new knowledge I think critically I perform with integrity I develop professional competencies I network with other professionals I communicate effectively I understand & am able to implement the problem solving process I contribute to our team I successfully navigate across boundaries I balance my life, work & school I ALWAYS embrace change

26 FORECASTING *Please note: I have not been in the position long enough to master the degree of forecasting, but here are some of the ideas I expect to encounter in the future*

27 Ideas On Forecasting 1) Establish the Business Need
*Patients, doctors, nurses, techs, administrative staff *What/how much supplies are needed in a day/month/year? *How much sedation medications and supplies must be ordered for our anesthesia group? 2) Acquire the Data *Use historical data of the past 2-5 years 3) Build the Model *Decide on a forecasting model to use *Cause & Effect currently in use in this facility 4) Evaluate the Results *Above model accuracy must be tracked & monitored

28 A General Marketing Plan
Logo: As seen on our website Develop a close relationship with established & future patients Stay current on new medical practices & procedures Promote medical services Offer great intangible services Make ourselves visibly seen in the community Promote our services through PCP’s for referrals Negotiate with insurance companies to be reimbursed at the highest rates Use different forms of media to promote our practice/clinic

29 Our Target Audience All potential patients of colonoscopy screening age/criteria in Anne Arundel and surrounding counties All potential patients experiencing GI symptoms or disorders All area Primary Care Physicians (to encourage them to refer their patients to us) All long-term facilities that would have the ability to refer their patients to us

30 Employee Retention Plan (& Motivation)
Employee retention is critical to the long term health & success of our practice Make sure every employee clearly knows what is expected from them every day of work Offer high-quality of supervision of employees Give the employee freedom to speak their mind Encourage innovation & leadership among employees Allow employees to use and fully demonstrate their talent and professional skills Encourage the employees to grow for the clinic and for their own goals Offer moments of praise during employee meetings for those employees who go over and beyond or who just do a great job Empower employees Offer rewards when merited Be timely with work appraisals Encourage health behavior Be mindful that peoples personal lives do not always stop at the door when coming to work Have open communication

31 Human Resources The Administrator (my direct boss) and I do all of the hiring and firing. We think alike, we have the same goals and the same expectations of all employees. This makes for a very formidable relationship! I only hire nurses/techs/support staff that I would want to be cared for if I was a patient. This process makes it very personal and causes me to choose only the best! Your looking at her!

32 Billing & Office Manager
Flow Chart Doctors & Partners Nurse Administrator (Me) Billing & Office Manager Laboratory Manager Medical Director (My direct boss) The remaining support staff falls under one of the appropriate 3 managers

33 Implementation of clear management expectations
Orientation around teamwork Implementation of clear management expectations Employees all treated fairly Instant feedback and constant reinforcement Consistency throughout clinic Emphasis on rewards Emphasis on long-term performance Foundation of adequate knowledge & skills Characteristics of good ACCOUNTABILITY

34 The Fundamentals of Accountability
Reduces human error by half Is motivation- oriented Improves staff members’ performance Promotes self- actualization Leads to Effective Work practices

35 Disaster Preparedness Plans
Internal Disasters External Disasters Types of Disasters: *Fires *Power Outages *Bomb Threats Types of Disasters: *Earthquakes *Hurricanes *Tornados *External Bomb Threats

36 Internal Disasters Reasons for Evacuation
*To remove patients and personnel from actual or threatened danger such as fire, explosion, etc. Implementation of Disaster Plan *The Administrator will be informed that an “internal disaster” is in effect. If fire is involved, they will call They will immediately notify all departments. *Patients will be evacuated from stricken areas to the far N.W. end of the parking lot. *Roll call with be taken before, during and after evacuation, if possible. *All patient charts will go with patients to be able to account for the patients in our care at that time.

37 External Disasters *The person receiving the communications from 911 will notify the Administrator who will then notify all of the department managers and ask them to notify the staff under them *All patients and staff will be moved to the lowest floor in the building *All patients and staff will be moved into the OR admitting area, which is the center of the building and has no windows *Cover all patients with blankets *All patients and staff will remain there until there is no longer a threat *Roll call will be done and all patients charts must accompany them for us to know who we are accountable for *Elevators will only be utilized for the movement of patients or equipment

38 Bomb Threat Procedure Notify authorities and key personnel POLICE
When a phone call is received: Prolong the conversation as long as possible; Be alert for distinguishing background noises, such as music, voices, aircraft, and church bells; Note distinguishing voice characteristics; 2 Ask where the bomb will explode, and at what time; Note if the caller indicates knowledge of the hospital by his/her description of the location. Notify authorities and key personnel POLICE Administrator All managers at work that day EVACUATION: *If a bomb is found, the police will notify the proper authorities to come and disarm it. If evacuation becomes necessary, this will be a decision of the Administrator.

39 *Local Surgery Center Manager Group
Networking I belong to the following groups that help me up-to-date on changes in standards of care. We also use each other as resources for all clinical questions and for networking. *Local Surgery Center Manager Group *Local GI Network

40 Succession There are two ways to prepare someone to fill my shoes for once I advance from this current position *Internal Succession: Choose an employee who has the skill, knowledge, motivation & desire to fill my shoes and tailor them to fit their future role as my successor. *External: Succession: There are two options here Hire someone to fill my shoes who already possesses the knowledge and experience of what I require. Hire someone; train and tailor them with the expectation that eventually they will take my place as manager.

41 My Retirement Plan 2023

42 One Final Note “Have fun in your command. Don’t always run at a breakneck pace. Take leave when you’ve earned it: Spend time with your families. Corollary: surround yourself with people who take their work seriously, but not themselves, those who work hard and play hard.” -General Colin Powell

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