Assignment Paper

After your review of the material, discuss your organization’s capacity for learning and change. Add in your
discussion why you believe your organization functions well or not, and identify any insights from the literature
you believe would help implement needed changes.
reading
Introduction
In this module you will learn about strategies to assess an organization’s readiness (and willingness) for
change. You will complete your first writing assignment by introducing your practice organization as a case
study using the Baldridge Excellence Criteria as a framework. Use the work throughout the module to create a
strong analysis of the organization along with implications and strategies for practice and future directions.
Your paper will be weighted heavily on the analysis and systems thinking portion so try and tie in the course
concepts as you move through the Baldridge domains. Some students find it helpful to get familiar with the
Baldridge domains prior to starting the module readings, this way you are viewing the readings through the lens of the assignment and the concepts can seem less nebulous.
It is largely understood that the organizational culture or climate impacts outcomes. These readings focus on
aspects of organizational contributions to outcomes. Remember that improvement will not occur until all
organizational layers are involved. Communication and accountability requires a bidirectional flow where
management is connected through governance structures with front line staff. As you review this material,
think about the material, consider the organizational supports to quality outcomes in your practice setting.
Theoretical perspectives
As you start working through the organizational material, I wanted to either introduce or reintroduce you to The
Theory of Structural Empowerment in Nursing. This theory under girds much of the Magnet Hospital work and
provides an excellent theoretical perspective that combines individual and organizational contributions to work
output and resulting outcomes.
This diagram models the variables in the theory:
Rosabeth Kanter’s Theory of Structural Power, initially derived from ethnographic research (Kanter, 1977,
1979) has been used in nursing to explain organizational empowerment in the workplace. Please read the
following article by Kluska, Laschinger & Kerr (1996) on empowerment in nursing Link to article (Links to an
external site.). This article is rather dense so focus on the concepts more than the data. I would also like you
to explore the synergies between this model and the Magnet® designation that I hope several of you are
familiar with:
Magnet Structural Empowerment (Links to an external site.)
Consider whether the empowerment structures you read about are present in your workplace.
Does your environment help you accomplish your work in meaningful ways? Do you have access to the
resources needed for your work? Do you have the time and appropriate resources with which to accomplish
your work?
Do you have access to the information you need to get the job done? Do you know the values and goals of
your hospital’s leaders? Are you aware of its financial status? Do you know the future direction leaders want to
take the hospital?
Do you feel your manager supports your responsibilities and job performance? Does your manager provide
specific information about tasks you do well? Does he or she give you tangible recommendations on how you
can improve? Do you believe your work is valued? What about rewards for contributing innovative ideas and
showing flexibility in your job?
Is your work visible within the organization as a whole? Do you work collaboratively with physicians and other
healthcare team members? Do they work collaboratively with you? Do peers and managers seek your help
with problems?
Does your employer give you the opportunity for professional growth and development? Is your work
challenging? Does it offer a chance to learn new skills and gain new knowledge? Do you have opportunities to
use all of your skills and knowledge? Do you believe your workplace is an empowering environment overall?
(Note: These questions come from the Conditions of Work Effectiveness Questionnaire, which measures structural empowerment within the work setting.) (Moore, 2014).
Hopefully by answering some of the questions above, the design of the writing assignment is starting to come
together for you. We are now starting to see how our environment influences our attitudes and perceptions of
change. You will essentially be evaluating these empowerment structures, using your organization as a case
study, and how those structures work or don’t work to promote a culture of continuous learning and quality
improvement. But how do we define those structures. The IHI gives a brilliant framework on developing
cultures of safety and reliability. Some of this may be familiar to some of you, but I think the next reading is
probably the most important piece that you will read in this entire course:
FrameworkSafeReliableEffectiveCareWhitePaper.pdfPreview the document
Many high-performing hospital organizations in the world have adopted this framework, you may even see bits
and pieces of the framework throughout your own organization (Lean, Team STEPPS, Relationship-Based
Care, Just Culture). At this point you have the theoretical background for nursing empowerment, you have a
framework to support a culture of empowerment; now, let’s bring it back down from theory to practice. Let’s
dig a little deeper into tactical solutions we can employ to empower nurses to be quality leaders, and to
catalyze the environment to support change:
Transparency (Links to an external site.)
Standard Work (Links to an external site.)
Management Systems (Links to an external site.)
Huddle (Links to an external site.)
Are there any other methods that your organization employs as a tactical solution to promote quality?
The next text is not required reading, but is HIGHLY RECOMMENDED. It is a relatively quick and easy read.
You can purchase from Amazon or Google Books.
Beyond Heros
Please read and review the following readings:
Press Ganey Special Report:
{b352868c-885f-4834-a6a4-05368fd2ed55}_2015_PG_Nursing_Paper.pdf (Links to an external site.) – (Links to an external site.)
Relationship between culture and performance.pdf (Links to an external site.)
Differences in the practice environment in US hospitals.pdf (Links to an external site.)
influence of context on quality improvement strategies.pdf (Links to an external site.)
characteristics of learning organization.pdf (Links to an external site.)
Also important when considering the organizational contribution to quality is the ability for systems thinking.
Systems thinking allows the leader to consider the multiple inputs involved in output. It is NOT linear, ie –
cause brings about an effect.
Systems theory
Image result for systems theory
Please review – Making the jump to systems thinking