LEADERSHIP FOR QUALITY AND SAFETY

NURSING 406Frostburg State University

Leslie Lister2012

Creative Implementation of Leadership

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The following presentation is an insight to my leadership abilities

My Personality

Humanmetrics Jung Typology Test

ENFJ1. Extravert 89%2. iNtuitive 75%3. iNtuitive Feeling 12%4. 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*

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

MY CURRENT LEADERSHIP ROLE:

Nurse Manager of Endoscopy Center

Newly obtained role as ofNovember 5, 2012

My FacilityMaryland Diagnostic & Therapeutic Endo Center

www.mdtecmd.com

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 15-35 patients/procedures a day

“Leadership is the art of accomplishing more than the science of

management says is possible.”

-General Colin Powell

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.

My Responsibility Regarding Legal Issues:

Practicing Ethical

Leadership&

Establishing an on-going relationship

Knowing about currentLegal trends

Encouraging nurses to speakUp about errors

Following the American

Disabilities Act&

The Family Medical Leave

Act

Communication&

Documentation

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

10 Ethical Principles To Follow As A

Leader

1. Frugality & therapeutic elegance: I recently did a Biohazard Waste Reduction Education which resulted in a 42% reduction of our biohazard waste costs.

2. 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.

3. 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.

4. Representing ethical concerns: Monthly meetings are held to address employees concerns and ideas. All of these are taken very seriously.

5. Loyalty: My clinic is my pride.6. Delegating ethically: Everyone has a job

description and employees are only asked to do what is asked of them in this description.

7. Responsible innovation: Change is brought about to ensure compliance, patient safety and employees well-being.

8. Fiduciary accountability: We follow standards of care and only bill for appropriate procedures.

9. Self-discipline: It is always wise to take a deep breath before answering any emotional question.

10. Continuous learning: As shown by my current enrollment in college.

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

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

Team Creation

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One Bad Apple Can Spoil The Bunch

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

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

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.

We were recently surveyed by the

AAAHCAccreditation Association for

Ambulatory Health Care

This agency provides voluntary accreditation which measures the quality of our services and performances against nationally recognized standards

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

• 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

• 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

WE PASSED !!!

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

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

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

FORECASTING

*Please note: I have not been in the position long enough to

masterthe degree of forecasting, but

hereare some of the ideas I expect

to encounter in the future*

Nursing

leve

ls

Cause

& E

ffect

Cente

r's p

rofit

Adve

rtising

0

0.5

1

1.5

2

2.5

3

3.5

4

4.5

5

Series 1Series 2Series 3

Ideas On Forecasting1) 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

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

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

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

Human ResourcesYour looking at

her!

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!

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

Orientation around

teamwork

• Implementation of clear management expectations

Employeesall 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

The Fundamentals of Accountability

Reduces humanerror by

halfImproves staff

members’performance

Leads toEffective

Workpractices

Ismotivatio

n-oriented

Promotesself-

actualization

Disaster Preparedness Plans

INTERNAL DISASTERS

Types of Disasters:

*Fires*Power Outages*Bomb Threats

EXTERNAL DISASTERS

Types of Disasters:

*Earthquakes*Hurricanes*Tornados*External Bomb Threats

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 9-1-1. 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.

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

Bomb Threat Procedure

When a phone call is received:a) Prolong the conversation as long as possible;b) Be alert for distinguishing background noises,

such as music, voices, aircraft, and church bells;

c) Note distinguishing voice characteristics;d) 2e) Ask where the bomb will explode, and at what

time;f) Note if the caller indicates knowledge of the

hospital by his/her description of the location.

Notify authorities and key personnela) POLICEb) Administratorc) 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.

NETWORKINGI 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

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 here1. Hire someone to fill my shoes who already possesses the knowledge

and experience of what I require.2. Hire someone; train and tailor them with the expectation that

eventually they will take my place as manager.

My Retirement Plan2023

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