SCHOOL OF NURSINGPYC COVER SHEET

Title of Exhibit: The impact of external constituents on education costs and services for

health care.

NONPF CORE COMPETENCY #5: Managing and negotiating health care delivery systems

NONPF Core Competency CATEGORY #5-3: Analyzes organization structure, functions, and

resources to affect delivery of care.

DSGNE Program Outcome #IV: Assume leadership and collaborative roles with other

disciplines and health care delivery systems for the purpose of improving health care.

PYC Specialty Program Outcome #1: Defines the role of the nurse practitioner within various

health care settings.

AACN Essential Standard #II: Organizational and systems leadership

AACN Element #II-3: Develop and understanding of how healthcare delivery systems are

organized and financed (and how this affects patient care) and identify the economic, legal, and

political factors that influence health care.

This Exhibit Contains: A CEU from the multi-disciplinary pain committee meeting, several

committee rosters, and an organizational review paper.

Rationale and Support: The Joint Commission has a safety goal for better pain assessment and

treatment within the scope practice for patient safety within all organizations (The Joint

Commission, 2012). Value-based purchasing, patient satisfaction scores, and reports for the

Hospital Consumer Assessment of Health care Providers and Systems (HCAHPS surveys) are

routinely discussed in the pain committee that I worked with. These measures of evaluation

where the patient is routinely having improved outcomes is indicative of accreditation and the

impact of the health care that is received within local organizations. At a University medical

GRADUATE PORTFOLIO – GRADUATE NURSING: PYC NURSE PRACTITIONER 2

center the collegiate influences are also prominent within the organization and this has economic

ramifications (Burke, 2005).

Reflection:

Change in the health care system with the initiation of the pain committee and having annual

meetings on pain control have improved the assessment, delivery of care and real time

reassessment of patients (The Joint Commission, 2012). The education on pain has increased

patient satisfaction scores and produced better safety outcomes by redesigning the pain

management program. Westover (2010) states that change agents will have the right people

working together to communicate the unified vision for synergy and effectiveness. In these times

of change, to reduce costs, and increase effectiveness in managed care it is imperative to have

successful strategies in the collaboration of care.

References:Burke, A. P. (2005). Effects of collegiate persuasion: A meta-analysis. Psychological Bulletin

106, 1-14. doi:10.1037/0033-2909.106.2290

The Joint Commission on Accreditation of Healthcare Organizations. (2012). Pain Management:

A systems approach to improving quality and safety. Retrieved from

http://www.jcrinc.com/downloads.aspx?type=FreeResources

Westover, J. H. (2010). Managing organizational change: Change agent strategies and

techniques to successfully managing the dynamics of stability and change in

organizations. International Journal of Management & Innovation, 2(1), 45-50.

Plagiarism Statement:

I have read and understand the plagiarism policy as outlined in the syllabus and the sections in the Catalog relating to the IWU Honesty/Cheating Policy. By affixing this statement to the title page of my paper, I certify that I have not cheated or plagiarized in the process of completing this assignment. If it is found that cheating and/or plagiarism did take place in the writing of this paper, I understand the possible consequences of the act/s, which could include expulsion from Indiana Wesleyan University.

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Place the Exhibit Here:

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The Impact of External Constituents

Colleges and universities possess a unique spot in American society. They are charged

with educating our youth to become contributing members of society; working to address social

problems and find cures for diseases. University faculty participates in cutting-edge research, to

address the problems and concerns plaguing our society. Yet, they are to accomplish all of this

under the auspices of state and federal demands: Which have shown to change stances with the

prevailing societal winds. Higher education is expected to respond to society’s latest “causes”

with programs, research, and unlimited enrollment. In the midst of this, responsiveness to

external concerns; they are mandated to remain true to their academic mission.

On the other hand, for institutions so dependent on external funding; they are strangely

reluctant to allow outsiders a glimpse into the inner workings and recesses of academia.

Universities loudly proclaim that they have a right to academic freedom and life without

interference. “Universities have generally had ambivalent relations with their surrounding

societies: both involved and withdrawn; both serving and criticizing; both needing and being

needed” (Burke, 2005, p. 4). The generally understood premise - within and outside academia -

is that colleges and universities are entitled to immunity from external pressures so that they may

critique the society they are mandated to assist. “They must simultaneously serve and scrutinize

the society that supports them” (Burke, 2005, p. 5).

However, those giving the money (sometimes lose patience) demanding to see proof that

their money was well spent. How do these two sides come to an agreement? Who is really

accountable to whom? Who has a right to say what should be taught and how? Also, who has a

right to demand a return on his or her investment? Many outsiders — looking in on the

unfamiliar inner workings of academia — believe higher education is “more interested in

autonomy than accountability - in demanding support than supplying services” (Burke, 2005, p.

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1). However Burke, (2005) believes that “too much autonomy encourages colleges and

universities . . . to slight society’s needs. Too much accountability produces dependent

institutions subservient to society’s whims” (p. 5).

State governments and public universities originally developed a distinct compact.

In return for financial support from taxpayers, universities agreed to keep tuition

low and provide access for students from a broad range of economic backgrounds,

train graduate and professional students, promote arts and culture, help solve

problems in the community, and perform groundbreaking research. Yet over the

past 25 years, that agreement has withered leaving public research institutions in a

purgatory of insufficient resources and declining competitiveness (Burke, 2005,

p. 14).

Government officials and business people are constantly asking colleges and universities

to offer new programs; and simultaneously complaining about them trying to be all things to all

people. Academic officials complain about being called indifferent when these same

government and business leaders change their minds so often about their priorities - based on

who is running for office.

Over the past 30 years, the university has been asked to respond to and emphasize several

different areas - all dependent on current societal events. The recession of the 1970s led states to

centralize their governments and place controls on public education. One strategy was to cut

available resources. This began the unraveling of the compact developed years earlier. “States

and society reduced support and demanded more services; colleges and universities requested

more funding and started raising tuition…” (Burke, 2005, p. 7).

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References

Burke, A. P. (2005). Effects of collegiate persuasion: A meta-analysis. Psychological Bulletin

106, 1-14. doi:10.1037/0033-2909.106.2290

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