Finkelman, Leadership and Management for Nurses: Core Competencies for Quality Care, 3e
Chapter 3 – Case Study Questions
This activity contains 3 questions.
Change: An Opportunity or a Disaster?
A home health agency is undergoing restructuring. This involves changes in staffing,
roles and responsibilities, scheduling, and client assignments. As the director of nursing
(DON), you are responsible for this change. You know it will be challenging. The staff is
about 50/50 new and long-term employees. One of your supervisors has openly expressed
his concern that these changes will not work. You know that the RNs will have to cover
more clients, but you have some flexibility in home health aide assignments. You don’t
want to lose RNs, but the changes have to be made.
1.
How would you use the deep dive process to implement these required changes?
2.
Apply the PDSA Cycle to this change initiative. Include barriers and strategies to
overcome.
3.
Describe an evaluation plan that you will use at 3, 6, and 12 months.
Finkelman, Leadership and Management for Nurses: Core Competencies for Quality Care, 3e
Chapter 3 – ANSWER KEY Case Study Questions
1.
Responses will vary. Information that may be included in the response is as follows:
The deep dive process is used by the TCAB initiative (Institute for Health Improvement,
2015). The TCAB pilots use this process of an in-depth brainstorming session to arrive at
methods to improve care at the bedside. The process, which can be applied to any type of
change effort, includes the following:
2.
Responses will vary. Information that may be included in the response is as follows:
It is important to determine if a change will actually improve the work processes and/or
Finkelman, Leadership and Management for Nurses: Core Competencies for Quality Care, 3e
3.
Responses will vary. Information that may be included in the response is as follows:
Evaluation should not be ignored. The measurable goals or outcomes developed earlier in