Final Discussion/Reflection Paper Write a one-to-two page reflection paper (no references). The purpose is for you to reflect on what was learned in the course thru the course objectives: how you applied and attained knowledge, skills, and attitudes to assist studies in your present and future health care career: any specific assignments that were helpful: the extent to which you achieved the course learning outcomes.

Expand on the following:

1. What has changed for you?

*Perceptions—changed or reinforced

*Deeper Learning

*New Quandaries or dilemmas

2. What were some of the most powerful learning experiences?

3. Have your perceptions about leadership and management changed in any way?

4. What areas will you continue to develop?

Topic: Leaders vs Managers

Objective

Different type of management style

Differentiate between leaders and managers

Topic : Legal and Ethical Issues in Leadersip

One of the nursing advocacy that is being addressed in ANA website is the Registered Nurse Staffing Act under “42 Code of Federal Regulations (42CFR XXXXXXXXXXb)) which requires certified hospitals that participate in Medicare to have “adequate numbers of licensed registered nurses, licensed practical (vocational nurses, and other personnel to provide nursing care to all patients as needed” (American Nurses Association, XXXXXXXXXXANA is working with lawmakers and legislators to make sure that safe staffing is being followed. To reinforce this act, Secretary of Human Health Services is given the authority to charge civil monetary penalties for each known violation. Also, hospital-acquired patient adverse events due to short staffing are subject for non-reimbursements from Centers for Medicaid & Medicare services (American Nurse Association, 2018).

I support Registered Nurse Staffing Act advocacy, because I am aware that it has major impact over patient care. Mandatory overtime and short-staffing could deplete staff functions, judgement, energy, compassion, and motivation towards patients and coworkers. Increased fatigue and stress could increase risk for work-site related injury, medication errors, and adverse patient events (bleeding, fall, infection).

Topic : St Lukes Organization Health Structure Presentation

Topic: Change Theory: Havelocks Model process and Rogers Change theory

Topic: Examining National QI Initiatives

Objective

Summarize the role of IOM reports (now the National Academy of Medicine [NAM]) in quality improvement

“Taking action against clinician burnout: a systems approach to professional well-being” was reported on National Academy of Medicine on October 2019. The report talks about the “six goals stakeholders should pursue to prevent and mitigate clinician burnout and foster professional well-being,” (NAM,2020).

1. 1.Creating a positive environment which promoteshigh-quality care, social support, and job satisfaction.

2. 2.Addressing burnout early during training or the early career stage by monitoring workload of licensure and training activities, implementing pass or fail grading, providing access to scholarships, and available repayment systems.

1. 3.Reducing tasks that do not improve patient care by regulating standards and regulations related to payment, health information technology, quality measurements and reporting, and professional and legal requirements for licensure.

2. 4.Improve usability and relevance of health IT by making EHR user-friendly, simple, reduce documentation demands, and automate non-essential tasks.

3. 5.Reduce stigma, replace punishments with education, and improve burnout recovery services such as employee assistance program, peer support programs, and employee mental health assistance.

4. 6.Create a national research agenda on clinician well-being facilitated by federal agencies by evaluating the cause of burnout, burnout implications to the workforce as well as the patient safety outcomes.

Nursing is one of the medical professions that are high risks for burnout and stress. Implementing this report will foster nurses and other health care worker’s well-being. Reducing burnout and stress increases job satisfaction, loyalty to organization, efficiency with healthcare delivery, quality teamwork which result into high quality patient care and satisfaction.

Topic: Delegating

Objective

Describe what your role isin delegation

Discussion Overview

This discussion forum explores the role of delegation.

National Council of State Boards of Nursing (NCSBN), has a standard process to delegation. The five rights to delegation are: “1. The right task. 2. Under the right circumstances. 3. To the right person. 4. With the right directions and communication. 5. Under the right supervision and evaluation,” (NCSBN, 2005, p.2).

Topic: Your Job Satisfaction

Objective

Describe the management strategies of recruitment and retention in leadership

Discussion Overview

This discussion forum explores the problems that your professions leadership faces every day when managing a group of employees. It addresses staffing concerns and patient safety. As a manager, you must be aware of the general morale among staff members and address any morale issues on a short- and long-term basis. You will need to apply your knowledge of recruitment and retention to address these concerns.

Topic: Evidence-Based Management

Objective

Explain the evidence-based management process for your profession

Discussion Overview

This discussion forum explores the use of evidence-based management on or in a medical professionalunit.

EVIDENCE BASED MANAGEMENT IN HEALTHCARE DQ.8

To make a decision using the evidence-based management process, I will follow Sacket’s 5 steps to evidence-based practice: current problem, search answer, critical appraisal, application, evaluation. First, I will identify the current problem, need for improvement, or needed change (e.g. staffing, budget, patient care, incentives). Second, I will gather the best possible evidence that is scholarly/peer reviewed from high quality sources (e.g. Cochrane database, Pub Med). After gathering the information, I will ensure its quality, validity, and applicability to my unit practice. Then with the help of my staff, we will begin the application of the new information to our daily clinical practices and patient’s preference. Lastly, I will evaluate the outcome effectivity or the need for more improvement, (Johnson, C XXXXXXXXXX).

After successful implementation and positive outcome, we will normalize the new practice/solution. I don’t think that using an EBP management style will hinder my creativity. I could still incorporate creativity with critical thinking and evaluating EBP process when making decisions. Sometimes, people, even managers and experts, make mistakes when making decisions based on personal judgements or intuitions.

In my understanding, in EBP management style, decisions and solutions are based on researching latest and best answers that are studied and proven to be effective. While with non-evidence-based management style, the manager makes a decision and solves problems based on his or her personal experience, knowledge, education, clinical expertise, personal judgement, or intuition.

Topic: Diversity Competencies

Objective

Explain how to manage a culturally diverse staff

Discussion Overview

This discussion forum explores diversity at your place of employment.

Lesson 10

How to Care Using Technology

Objective

Describe how leaders apply informatics standards

Discussion Overview

This discussion forum explores how leaders can use informatics in your profession.

Patient Centered-Care:

To fulfill the goal of A New Health System for the 21st Century, the Institute of Medicine (IOM) set forth standards, the six aims for healthcare improvement in the public and private sectors which are: safety, effective, patient-centered, timely, efficient, and equitable. The first aim of safety first means no harm must be done to every patient while receiving healthcare. Second aim is effective; healthcare services must be scientific based knowledge and the right care and right treatment for the right patient. The third aim is patient-centered care which means each patient is unique, culturally and spiritually. Preferences must be taken into consideration when providing care, and most importantly, the patient makes the final decision towards their health. Fourth aim is timely, which means immediate and prompt care should be provided. Reduced wait times and prompt service, benefits both patients and the healthcare system. Fifth aim is efficient, which means avoiding waste of supplies, energy, equipment, and ideas to conserve costs for better allocating of funds. Lastly, the sixth aim, equitable meanseveryone should receive high quality care regardless of socioeconomic status, race,gender, ethnicity, and geographic location, (Agency for Healthcare Resource and Quality, 2020)

Topic: Health care finance: Medicare or Medicaid?

Objective

Describe the leader's role in national health care finance

I compared and contrasted the Medicare and Medicaid programs in the state of California.It is interesting that theMedi-Cal covers Refugee assistance, foster care and adoption assistance. A big challenge I pointed out is reimbursement.

One of the greatest challenges that are encountered by the leaders in Medicaid is inselecting the person who qualifies for the reimbursement. The Medicaid was designed not to serve only the poor, and also it was not designed to meet all the healthcare needs of an MEDICAID AND MEDICARE 2

individual. The eligibility of Medicaid was closely linked as well as limited within the categorical groups of income levels which were defined by the Cash Assistance program (Chelminsky, XXXXXXXXXXHowever, exceptions were provided to a certain standard of poverty which does not align with the Federal poverty level. In addition, it only provides a core set of essential services which the state exercises without including the additional health services to the Medicaid-eligible population.