Nursing Chapter 1 Homework Potential Leadership And Management Capabilities Individuals

Chapter 1: The Health Care System: Environment for Nursing Leadership

Learning Outcome 1

Identify the major forces dominating the health care system today.

Concepts for Lecture

2. Currently, health care services are driven by managed care, professional issues (such as

PowerPoint Slides

1. Forces influencing the health care system

• Rising cost

2. Current drivers of health care services

• Managed care

Suggestions for Classroom Activities

Learning Outcome 2

List the factors that contribute to the rising cost of health care.

Concepts for Lecture

1. Factors contributing to the rising cost of health care are the U.S.’s having the best health

PowerPoint Slides

1. Factors contributing to rising health care costs

• Best health care compared with the rest of the world

Suggestions for Classroom Activities

• Have the students research one of the factors that contribute to rising health care costs.

Reference

Learning Outcome 3

Analyze the issues that impact the nursing shortage.

Concepts for Lecture

1. Nursing employment trends show that there is less tendency for those born after 1960 to

2. The shortage is magnified by the high turnover rate of those who have been newly hired,

3. Enrollment in nursing schools is not growing fast enough for the shortage. Although there

4. Implications of the shortage threaten the health of the nation; it is expected to impact the

quality of care and hospital staffing, resulting in problems including reduced access to

PowerPoint Slides

1. Nursing employment trends resulted in decline of registered nurses in 1980s and ’90s

2. High turnover rate of newly hired nurses

3. Enrollment in nursing schools

4. Implications of the shortage threaten the nation’s health

• Impacts on the quality of care and hospital staffing are expected.

Suggestions for Classroom Activities

• As a homework assignment, have students research nursing shortages in their area or

Reference

• American Association of Colleges of Nursing (2007). Nursing shortage: Fact sheet.

• Hayes, J., Scott, A., (2007). Mentoring partnerships as the wave of the future for new

Learning Outcome 4

Concepts for Lecture

1. Leadership is a more fundamental and creative coordinating process, but also requires an

2. Management organizes the actions that will use resources most efficiently and

3. Both skills are needed for successful operation of any organization. Both skills might be

PowerPoint Slides

1. Leadership

• Fundamental, creative coordinating process

2. Management

3. Leadership and management’s role in running an operation

• Both skills needed for success

• Both skills might be present in one person, but not always:

Case Study: New Graduate Employment in a Community Hospital

Suggestions for Classroom Activities

• Have students create a Venn diagram illustrating skills related to the concepts of

Reference

• Bennis, W., and Nanus, B., (1985). Leaders. The strategies for taking charge. New

Learning Outcome 5

Concepts for Lecture

1. A behavioral–situational framework is the necessary behavior the nurse leader should use

to achieve a goal. The appropriate behavior depends on those affected and conditions

2. New leaders have the challenges of developing new and efficient methods of nursing care

using older and fewer nurses; influencing the working conditions for professional nurses;

3. Identifying potential leadership and management capabilities of individuals is critical in

4. Identifying valuable traditions and practices through the efforts of nurse managers, nurse

PowerPoint Slides

1. Behavioral–situational framework

2. New leaders in current health care system

• Might have mandatory preparation and mentoring.

3. Potential leadership and management capabilities of individuals

4. Identifying valuable traditions and practices unifies the profession through efforts of:

• Nurse managers

Suggestions for Classroom Activities

• Create two or three different situational leadership examples and then lead students

Learning Outcome 6

Analyze U.S. policy on financing health care delivery.

Concepts for Lecture

1. Managed care is intended to provide health care to patients through a highly coordinated

2. The events leading to the development of managed care began in the 1950s; before that,

health care was fee-for-service, which increased costs due to vast expansion of the health

3. This new altered version of the health care industry sparked major insurance companies

4. Health care costs continued to rise despite the new payment systems and ceilings in place

5. Managed care characteristics represent the general mechanisms used in most managed

care organizations (MCOs), which are responsible for the format of managed care plans.

a. The cost, quality, and value of care are evaluated by each MCO and national agencies

b. Utilization management is providing appropriate, cost-effective care based on

c. Primary care, typically provided in ambulatory care settings, is the chief mechanism

by which preventive, therapeutic, and restorative care is provided in the least

d. Interdisciplinary care and interdependence are necessary components of health care

e. The contract process is ever-evolving, but is always used to inform all parties of the

financial risk and services received. The integral components of the contract:

i. Contracted health plans: basic set of agreements an organization will provide

its members

6. Managed care models are all unique and complicated, initially derived from the medical

industrial complex, but currently involve a variety of networks. Organizations providing

managed care can be for-profit or not-for-profit, depending on the legal and financial

imperatives.

a. Health maintenance organizations (HMOs): initial prototype of managed care; an

entity ensuring services in a specific area, providing basic and optional benefits

i. Staff model HMO: Self-contained organization; delivers members’ care

iii. Network model HMO: contractual agreements with small medical practice

b. Preferred provider organization (PPO): Entire network of providers to

c. Point-of-Service: Members choose providers within or out of network offered; if they

d. Carve-outs: method of providing services not included in the regular contract, such as

PowerPoint Slides

1. Managed care

• Provides care through a highly coordinated network of providers and services.

2. History of managed care

• Before 1950: fee-for-service–based health care

3. History of managed care, cont’d.

• Major insurance companies soon created their own plans to compete with the

4. History of managed care, cont’d.

5. Managed care characteristics

• Quality is monitored and evaluated.

6. Managed care models

• Health maintenance organizations (HMOs)

o Staff model HMO

Figure 1.1: The dominant elements of nursing’s values for health care reform

Suggestions for Classroom Activities

• Break the class up into small groups and assign each group a different managed care

Reference

• Shi, L., Singh, D. (2004). Essentials of the US health care system. Jones & Bartlett

Publishers.

GENERAL CHAPTER CONSIDERATIONS

2. Have students complete the end-of-chapter exercises either in their book or on the

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