Business Management Unit 3 Aos 3 Notes
Kandy Swartzel
Slide 1. Cover Slide.
Slide 2. Learning Objectives
Slide 3. What is a Nurse Manager?
Slide 4. Why Are Nurse Managers So Important?1, 2, 3, 4
Slide 5. The Nurse Manager's Dual Roles
Slide 6. Oversee Unit-Based Operations
Slide 7. The Leadership and Management Roles of the Nurse Manager
Slide 8. The Nurse Manager as a Mentor and Coach
Slide 9. Responsibilities of the Nurse Manager
Slide 10. Human Resource Management4
Slide 11. Encourage Professional Development of Staff
Slide 12. Customer Focus
Slide 13. Financial Responsibility
Slide 14. Standards of Care
Slide 15. Alignment with Organizational Goals5
Slide 16. Frameworks that are Useful for Nurse Managers
Slide 17. The Baldridge Health Care Criteria for Performance Excellence Framework6
Slide 18. Quint Studer's Five Pillars7
Slide 19. Balanced Scorecard8
Slide 20. The American Organization of Nurse Executives Nurse Manager Leadership Partnership Learning Domain Framework9
Slide 21. Measurement Tactics: Customer/Patient Focus
Slide 22. Work Alignment
Slide 23. Quality/Safety
Slide 24. Financial
Slide 25. Summary
Slide 26. CUSP Tools
Slide 27. TeamSTEPPS Tools
Slide 28. References
Slide 29. References
Slide 30. References
The Role of the Nurse Manager module of the Comprehensive Unit-based Safety Program (or CUSP) Toolkit addresses the role of nursing leaders for your quality improvement initiative. This module explains the responsibilities of the nurse manager, leadership and management roles of the nurse manager, key business and health care quality improvement frameworks, and quality measurement.
Nurse managers work with their staff to coordinate all aspects of daily patient care on the unit. By ensuring that staff, patients, and patients' families are communicating, nurse managers help unit staff members deliver the safest possible care.
The CUSP framework is a proven tool that nurse managers can use to improve the safety culture on their unit. Nurse managers are the leader of their unit and can influence the unit's culture and ability to embrace change. Nurse managers can support their unit's CUSP activities by integrating CUSP principles and tools into the unit's workflow. Because nurse managers are in a position to align the unit's goals and processes with a culture change framework, they play an integral role in the support of a unit's CUSP work.
Serving in this capacity, nurse managers are change agents on their unit. They work with staff to initiate new policies and procedures that help the unit team achieve their quality improvement goals and sustain their CUSP efforts. Nurse managers lead their unit staff in preventing patient harm in their unit, empowering nurses to be the first line of defense against patient harm.
Nurse managers maintain two roles within the unit: They deliver clinical care and serve as administrative leaders on their unit. When nurse managers interact with an administrator, they wear one hat. When nurse managers interact with unit staff, they wear a different hat. These two groups can have different agendas, and the nurse manager has the unique position of understanding both groups. Nurse managers are a conduit for communication and comprehension between the two groups to move the unit toward the hospital's strategic goal.
Nurse managers can also apply their position to support the unit's CUSP work by engaging unit staff and hospital leaders. Nurse managers can help the CUSP team implement Just Culture principles on their unit to reinforce peer-to-peer coaching and mentoring. As part of their administrative duties, nurse managers can ensure the unit has the resources it needs to initiate and sustain its CUSP intervention.
Identify areas within your CUSP team's work where your unit's nurse manager can assist your team. Try to identify one administrative and one staff-focused area for which your team would like help from unit-level management.
Nurse managers lead their unit staff by providing their vision for the unit's progress toward excellence. Nurse managers are the change agents for the unit and make decisions that guide the unit's activities. They work closely within their unit to inspire, motivate, and engage administrators, unit staff, and customers. (Customers are discussed later in this module.)
In their leadership role, nurse managers use a socio-adaptive skill set that encourages the use of teaching, coaching, and Just Culture principles to engage unit staff and support unit-based initiatives by ensuring close working relationships among unit team members.
Nurse managers in their management roles use a task-oriented, technical skill set. This skill set enables nurse managers to support the unit's work through working with the team to ensure the team has the necessary resources and materials needed to initiate and sustain their intervention.
Embodying these leadership and management skill sets in their daily work helps nurse managers successfully lead and manage the activities that take place on their unit while supporting the quality improvement work of their staff.
Nurse managers are responsible for managing human and financial resources; ensuring patient and staff satisfaction; maintaining a safe environment for staff, patients, and visitors; ensuring standards and quality of care are maintained; and aligning the unit's goals with the hospital's strategic goals.
Nurse managers are responsible for hiring, training, and developing employees; thus, nurse managers require strong coaching skills. When working with staff to achieve their human resources goals, nurse managers must obtain staff satisfaction feedback regularly. Once they analyze the feedback, they can develop a plan to start the programs and training staff members suggest. Nurse managers' work in this area supports the work of the CUSP team by providing a means of spreading training or methodologies using unit-wide curriculum.
When hiring staff, nurse managers ensure the unit's staffing needs are met in the most economical way possible so funds that would otherwise be used for recruitment can instead be spent on retaining high-performing staff.
In addition to hiring and training efforts, nurse managers work closely with staff on professional development. As staff members grow within their roles on the unit, nurse managers mentor staff members. These professional development opportunities allow nurse managers to hire from within when positions become open on the unit. Promoting positions internally and developing staff for these positions helps increase teamwork on the unit.
Nurse managers work with the staff to improve the systems on the unit by applying good system design. When nurse managers work with staff to develop good systems, they are supporting CUSP quality improvement efforts on their unit. By critically reviewing system-level breakdowns, nurse managers are working closely with unit staff to use the Science of Safety principles of safe design.
Nurse managers also manage behavior. Managing behavior calls for nurse managers to use empathy, coaching skills, and discipline when working with their staff. The Just Culture framework supports nurse managers' work because it engages staff and supports teamwork and communication on the unit. Further, it engages staff to collaborate and coach one another to deliver optimal levels of care.
Nurse managers ensure the care delivered on their unit is customer focused. The hospital unit has numerous customers, and each has its unique needs and care delivery requirements. Nurse managers are responsible for ensuring the needs of customers are met.
Nurse managers work with patients, families, and unit staff to develop patient- and family-focused care plans. Involving patients and their families in their care ensures the best possible care for the patient and creates a supportive and caring environment in which staff members are able to work closely with patients and their families.
Nurse managers must also adhere to the requirements of regulatory agencies and organizations, such as the Joint Commission and the Centers for Medicare & Medicaid Services. The regulations of these organizations will determine almost all components of care delivery and staffing needs on the unit.
Local governments take an active interest in the quality of care their local hospital delivers to the community. Nurse managers ensure the goals of the local government are embodied on the unit and community members receive the highest quality of care possible.
Nurse managers ensure staffing costs remain within the budgeted amounts. They prepare for fluctuations in staffing needs without accruing staff overtime, and when staffing needs overwhelm unit resources, they are responsible for budgeting for temporary help. Nurse managers also support the efforts of the CUSP team by helping the team develop a way for its work to be completed within available staffing resources.
Nurse managers are responsible for the maintenance of operating and physical plant costs for the unit. They are responsible for ensuring these costs are kept at a minimum while making sure the needs of the unit are met.
The nurse manager makes sure that staff members have access to the equipment and supplies they need to complete their CUSP interventions. While the senior executive member of the CUSP team helps the team secure resources, it is the responsibility of the nurse manager to ensure that the team is able to effectively use those resources. When these items become expensive, the nurse manager needs to create a solution that satisfies the needs of their staff and does not compromised patient care.
Nurse managers understand the professional and regulatory guidelines (e.g., Centers for Disease Control and Prevention, Joint Commission, Centers for Medicare & Medicaid Services) that govern patient care. Regulating agencies and insurance companies mandate that hospitals provide evidence-based clinical practices as the standard of care. Nurse managers are responsible for making sure their staff members are educated on standards of care and any changes to those standards so that staff members are able to provide the safest care possible on the unit.