NURS_ADV-524-jason.meade-2025-02-10-02-40-19

1. Critically evaluate leadership theories and frameworks to identify best practices in managing complex healthcare organizations.

Individual Lessons Learned

Non-Clinical Practicum

2. Analyze healthcare systems and processes to identify opportunities for quality improvement and innovation in nursing practice.

Group Exercise #2

Individual Lessons Learned

Non-Clinical Practicum

3. Design strategies for change management that address improved patient-centered outcomes.

Group Exercise #1

Group Exercise #2

Individual Lessons Learned

Non-Clinical Practicum

4. Assess the impact of public health policies on healthcare organizations and nursing practice. 

Group Exercise Project #3

Week 1

Introduction to Managing in Complex Systems  

Review Course and Practicum Expectations and Assignments

Synchronous Class via Zoom

Group Contract is in Canvas

Group Contract is

Analyze and Recognize Quality Advance Nurse Leadership Skills

*Components of Leadership Competencies

Read: Knowles (2021): Chapters 5 & 6

Leader Competency Framework

Ruben, DeLisi, & Gigliotti (2021): Chapters 7,8,9

Transition to Leadership

What is Leadership?

The Competency Approach: Integrating Leadership Knowledge and Skill

Lecture in Canvas

Analyze the components and principles of leadership:

Leadership Competencies

1. Define and understand the essential elements of the leader’s role in management:
2. Vision
3. Emotional Intelligence
4. Decision-making
5. Accountability
6. Resilience
7. Communication
8. Team and Relationship Building
9. Integrity
10. Problem Solving
11. Change Management

Read and review the five domains of Nursing Leadership: Communication and Relationship Building, Leadership, Knowledge of the Health Care Environment and Clinical Principles, Professionalism, and Business Skills and Principles.

AONL Nurse Leader Competencies: Core Competencies for Nurse Leadership

Hughes, Ronda et al.

Nurse Leader, Volume 20, Issue 5, 437 - 443

World Health Organization (WHO). (2014). Leadership competencies framework on patient safety and quality of care. https://cdn.who.int/media/docs/default-source/patient-safety/leadership/health-service-delivery-for-leaders.pdf?sfvrsn=292fb372_7

Register for free online access to this framework.

Sigma Theta Tau International. (2024). Global Nursing Leadership Competency Framework Competency Development—Nursing Levels and Definition

https://www.sigmanursing.org/global-nursing-leadership-competency-framework

Submit Practicum and Mentor Agreement via Dropbox in Canvas 

Lessons Learned 1

Advanced Nurse Leader Skills

Read: Ruben, DeLisi, & Gigliotti (2021)

Chapter 12

Respond to questions page 209:

1. What are your aspirations as a leader--- your vision of leadership?
2. How would you like to be viewed by others---your leadership identity?
3. For what will you be uniquely known as a leader---your leadership brand?
4. What would you like your lasting contribution to be---- your leadership legacy?

Describe in detail the responses supported by evidence in-text citations. As you do this, provide an evaluation of the leadership theories under consideration.

The responses should be substantive, succinct and precise with appropriate professional language. Use in-text citations and references in the correct APA style. (250-300).

Due by Sunday of Week 4 by 1159pst

 Leadership Assessment 

Read:

Dugan (2017). Chapter 4 Person-Centered Theories

Ruben, DeLisi, & Gigliotti (2021)

Chapter 12: Leadership Self-Assessment and Reflective Practice (WSU Library)

Lecture in Canvas

Review and Discuss:

Personal Leadership Development

Page 208

1.Clarify your leadership philosophy

2. Assessing strengths and areas for improvement

3. Commitment

4. Establish a Leadership Development Plan

5. Follow through

Assessing Leader Behaviors:

*360 Feedback

*Myers-Briggs

*Gallup Leadership Assessment

Carrara, G. L. R., Bernardes, A., Balsanelli, A. P., Camelo, S. H. H., Gabriel, C. S., & Zanetti, A. C. B. (2018). Use of instruments to evaluate leadership in nursing and health services. Revista Gaúcha de Enfermagem, 38(3), e0060–e0060. https://doi.org/10.1590/1983-1447.2017.03.2016-0060

Synchronous Class via Zoom

Live Review:

Leadership Theories

*Examine key leadership theories and concepts in healthcare

Read:

Chaos Theory. (2024). IntechOpen

(available WSU eBook) (Reference)

Haigh CA, C. A. A. (2008). Using simplified chaos theory to manage nursing services. Journal of Nursing Management., 16(3), 298–304. https://doi.org/info:doi/

Uhl -Bien, M., & Arena, M. (2017). Complexity leadership: Enabling people and organizations for adaptability. Organizational Dynamics, 46(1), 9–20. https://doi.org/10.1016/j.orgdyn.2016.12.001

Weberg, D. (2012) Complexity leadership: A healthcare imperative. Nursing Forum 47: 4, October-December 2012. Wiley Periodicals

Lecture in Canvas

Complexity Leadership: a framework that blends “collaboration, complex systems thinking, and innovation mindsets. Compared to transactional and transformational leadership concepts, complexity leadership practices hold promise to improve cost and quality in health care.”

Key Leadership Theories:

*Chaos Theory

*Change Management

*Healthcare Innovation

*Leadership Theory

Explore leadership, management, and change theories for the delivery of cost-effective, quality outcome healthcare.

Practicum Update #1 Due 

Lessons Learned 2

Complexity Theory and Leadership Model

Compare and contrast traditional leadership style, behaviors, and principles versus the style, behaviors, and principles of Complexity Leadership.

Explore the relationship between management and leadership in complex healthcare systems.

Are they one and the same?

Are they interchangeable?

Explain the prevalent leadership style and model in your practice environment.

Describe in detail the responses supported by evidence in-text citations.

The proposal should be substantive, succinct and precise with appropriate professional language. Use in-text citations and references in the correct APA style. (250-300).

Due by Sunday of Week 6 by 1159pst

Complex Healthcare Systems

Read the articles noted below.

Lecture in Canvas

What makes a healthcare system complex?

Characteristics:

*Network of interconnected parts

*Interdependence between individual parts of the whole that impact the entire systems over the individual parts.

*Requires flexible and adaptable team members to embrace fluctuations in technology, market dynamics, & data-driven outcomes

*Reliant on interdisciplinary and multi-departmental communication, collaboration, and informed decision-making processes.

Analyze factors contributing to the increasing complexity of healthcare systems:

*Aging population

*Patient literacy

*Shortage of human resources

*Increased demands of the consumer, providers, and payer sources

*Aging infrastructures

*Demands for advanced medical equipment

*Evolving technology

*Regulatory requirements

*Uninsured

*Underinsured

Successful complex systems are in alignment with their mission, vision, and culture driven strategic plans. Advanced nurse leaders utilize complexity leadership strategies that foster innovation, creative thinking, and process improvement techniques.

Team relationships, in conjunction with key stakeholders, embrace flexible, adaptive, and transparent behaviors.

Levitt L, Altman D. Complexity in the US Health Care System Is the Enemy of Access and Affordability. JAMA Health Forum. 2023;4(10): e234430. doi:10.1001/jamahealthforum.2023.4430

Lipsitz L. A. (2012). Understanding health care as a complex system: the foundation for unintended consequences. JAMA, 308(3), 243–244. https://doi.org/10.1001/jama.2012.7551

Lessons Learned

Dynamic Complexity 3

1. Read the Case Study: Exercise 3 Page 281

Follow the instructions, refer to Spath (2022) Chapter 3.

2.Review supplemental reference noted in the case study.

3.Explain how these system characteristics are expressed in the case study

Describe in detail the responses supported by evidence in-text citations.

The proposal should be substantive, succinct and precise with appropriate professional language. Use in-text citations and references in the correct APA style. (250-300).

Due by Sunday of Week 7 by 1159pst

Group Project Exercise #1

Quality Improvement

Patient Satisfaction

 And

Nursing Innovation 

This is a group team exercise. Follow the group contract from week 1.

“Quality improvement (QI) in nursing is a systematic process that uses data to improve patient care and outcomes. Nursing innovation is the creation of new models of care, safety practices, and processes to improve patient outcomes.”

SCENARIO:

Based on recent patient satisfaction survey feedback and a recent regulatory agency survey, patients served by your organization’s care coordination clinics, report a lack of understanding of condition specific self-care regarding medications, nutrition, exercise, and symptoms to report to their provider.

The Joint Commission has tasked the CNO with the development of an action plan to address the consumer’s needs.

TEAM GROUP:

The Clinical Excellence Committee (CEC) has been tasked by the CNO to design strategies for change management and innovation in nursing practice that address improved patient-centered outcomes.

The group team members comprise the CEC. The person-centered strategies will be designed and implemented across the various outpatient clinics.

Address the following elements of care coordination:

*Connect patients with the right care professionals, and ensure that care plans are effective 

*Help patients understand their conditions and how to manage their care 

*Track a patient's progress and make adjustments to their care plan as needed 

*Ensure that patients have the necessary follow-up appointments, and that they understand their discharge instructions 

*Look for areas where care might be duplicated or missing, such as screenings or follow-up visits

*Details under Assignments and Assessments.

Refer to Group Exercise Grading Rubric

Dedicated Group Exercise 1 Work Session

Due by Sunday of Week 8 by 1159pst

Patient Safety in Complex Systems

Read: Spath (2022), Chapter 4 Understanding System Behavior

Knowles (2024), Chapters 1-4.

Human Errors

Systemic Errors

Organizational Factors

Individual Factors

Read:

“Understanding variation in such a way creates a shift in methodology from a deterministic to a probabilistic approach, which is more appropriate for understanding causation within complex systems.”

Stretton P. Beyond root cause analysis: How variation analysis can provide a deeper understanding of causation in complex adaptive systems. Journal of Patient Safety and Risk Management. 2021;26(2):74-80. doi:10.1177/2516043521992908

Systems and the effect of complexity on patient safety.

https://cdn.who.int/media/docs/default-source/patient-safety/curriculum-guide/resources/ps-curr-handouts/course03_handout_systems-and-the-effect-of-complexity-on-patient-care.pdf

Synchronous Class via Zoom

Group Class Discussion:

“Every organization is perfectly designed to get the results that it gets” Spath (2022). pg.60

The Iceberg Metaphor

*Organizational Structure

*Systemic Structure

Watch “How to save your life in a complex healthcare system” by Claire Snyman.

https://www.ted.com/talks/claire_snyman_

how_to_save_your_life_in_a_

complex_health_care_system

 Azpilicueta, J. (2024).  Healthcare leadership: Navigating in the era of complex adaptive systems. https://www.ie.edu/lifelong-learning/blog/business/

healthcare-leadership-in-the-era-of-complex-adaptive-systems/#:~:text=The%20application%20of%20the%2

0theory,healthcare%20agent's%20interest%

20and%20progress.

Practicum Reflection #2 Due 

Lessons Learned 4

Complex Adaptive Theory

You are the Director of Innovation at the WSU Medical Center. The CNO has requested an executive summary outlining in detail the potential value of adopting Complex Adaptive Theory principles to address creative problem solving, adaptability, and learning.

Executive Summary:

Include clinical decision-making, professional silos, and adaptive thinking, learning, and leadership.

Highlight the anticipated impact of patient-care outcomes and quality improvement data indicators. 

The response should be substantive, succinct and precise with appropriate professional language. Provide details to give depth of understanding to this learning objective. Use in-text citations and references in the correct APA style. (250-300).

Group Project Exercise #2

Nursing Innovation

EBP Committee

Group Team Members

The scenario and assignment are outlined below:

The Chief Nursing Officer has asked the Washington State University Center’s Masters prepared nurse directors to champion an Evidence-based Practice Committee.

The CNO has requested that you prepare a detailed design project that addresses the following:

Detailed Steps:

1. Initiation and Planning:

• Identify Need:

Recognize areas within the practice where evidence-based improvements are needed. 

• Leadership Support:

Secure commitment from leadership to establish and support an EBP committee. 

• Committee Composition:
  • Recruit diverse members with expertise in clinical practice, research, data analysis, and relevant specialties. 
  • Include nurses, physicians, administrators, librarians, and patient representatives where applicable. 

2. Committee Structure and Function:

• Define Scope:

Clearly outline the committee's focus areas (e.g., specific clinical practice issues, quality improvement initiatives). 

• Establish Roles:

Assign roles like chair, co-chair, evidence reviewers, project leads, and data analysts. 

• Develop Guidelines:

Create a structured process for identifying clinical questions, searching for evidence, critically appraising research, and making recommendations. 

3. Evidence Review Process:

• Formulate Clinical Questions:

Use the PICO (Patient, Intervention, Comparison, Outcome) framework to develop focused clinical questions. 

• Literature Search:

Conduct comprehensive systematic literature searches using appropriate databases and search strategies. 

• Critical Appraisal:

Evaluate the quality of evidence based on methodological rigor, validity, and applicability to the clinical context. 

4. Implementation and Evaluation:

• Develop Practice Guidelines:

Translate evidence into clear, actionable practice recommendations. 

• Dissemination Plan:

Communicate new guidelines to relevant stakeholders through education, training, and clinical updates. 

• Monitor Outcomes:

Track key performance indicators to assess the impact of implemented changes. 

• Feedback Loop:

Continuously evaluate and refine practice guidelines based on new evidence and practice experience. 

*Details under Assignments and Assessments.

Refer to Group Exercise Grading Rubric

Dedicated Group Exercise 2 Work Session

Consider the following areas for EB Improvements:

Polypharmacy

Post-surgery mobilization

Safe opioid care in primary care

Community Care Coordination

Identify Committee Composition by role, not name.

Include the elements of population diversity in the community.

Do not conduct an actual literature search, but do propose databases or assign focus committee members to conduct.

Include evidence-based in-text citations to support this project.

Due on Sunday of Week 11 by 11pst

Change Management to Improve Patient-centered Outcomes

Read: Spath (2022). Chapter 6 Fostering Collaboration and Teamwork

Chapter 4, pages 64-68. Mental Models

Boström, J., Hillborg, H., & Lilja, J. (2023). Balancing a seesaw – leaders perspectives on design and traditional quality improvement in healthcare. TQM Journal, 35(9), 173–190. https://doi.org/10.1108/TQM-07-2022-0219

Lecture in Canvas

*Leadership Activities in Team Building,

Collaboration, & Team Effectiveness

*Role of the Nurse Leader in Ethical Decision-making

*Staff Training and Advancement

*Patient and Family Engagement

*Data-driven Decision-Making

Strategies:

Implementation of an interoperable electronic health record (EHR)

Adopt evidence-based practices

Promote patient self-management

Patient feedback through surveys and focus groups

Health promotion to meet consumers in their communities

Lessons Learned 5

The SHARE Approach

The SHARE Approach. Content last reviewed October 2024. Agency for Healthcare Research and Quality, Rockville, MD.
https://www.ahrq.gov/sdm/share-approach/index.html

Read: SHARE APPROACH

Watch Video

1. Essential Elements of Shared decision-making.
2. Decision Aids: What they are and how to implement them.
3. Communication barriers and solutions

Design 5 open-ended questions to actively elicit patient’s thoughts and goals regarding their healthcare and wellness plan.

Identify 5 patient specific barriers to communication that are essential for nurses to mitigate throughout the communication process.

Offer strategies to mitigate these barriers.

Describe in detail the responses supported by evidence in-text citations.

The response should be substantive, succinct and precise with appropriate professional language. Provide details to give depth of understanding to this learning objective. Use in-text citations and references in the correct APA style. (250-300).

Due by Sunday of Week 12 by 1159pst

Read:

Spath (2022). Chapter 2

Wichaikhum, O., Abhicharttibutra, K., Nantsupawat, A., Kowitlawakul, Y., & Kunaviktikul, W. (2020). Developing a strategic model of participation in policy development for nurses. International Nursing Review, 67(1), 11–18. https://doi.org/10.1111/inr.12571

Lecture in Canvas

Safety Net Systems

Food Banks

Soup Kitchens

Volunteers to enroll the homeless in programs

Watch TED Talk: What the US health care system assumes about you. By Mitchell Katz

https://www.ted.com/talks/mitchell_

katz_what_the_us_health_care_

system_assumes_about_you/transcript

Next week’s group exercise #3 is designed to assess and explore the impact of healthcare systems and community care providers.

Focus this week on the impact of health policies on healthcare organizations and nursing practice related to your area of practice.

Specific areas to assess:

1.Scope of practice changes:

How does the policy affect the scope of practice for nurses, allowing them to perform additional tasks or requiring new skill sets?

2. Clinical practice guidelines:

Does the policy influence the development or implementation of new clinical guidelines for nursing practice?

3. Patient education and outreach:

How does the policy impact the need for patient education and community outreach initiatives by nurses?

4. Care coordination:

Does the policy facilitate or hinder care coordination efforts between nurses and other healthcare providers?

5. Resource allocation:

How does the policy impact the allocation of nursing resources within the organization?

Group Project Exercise #3    

Change Management and Innovation Project

Population Health Community Collaborative

Chronic Health Management

Group Team Members

The scenario and assignment are outlined below

Read:

Barrow JM, Annamaraju P. Change Management In Health Care. [Updated 2022 Sep 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459380

Apply Kotter’s 8-Step Change Model, developed in 1995, includes the following steps for effective change management:

1. Create a sense of urgency for change
2. Form a guiding change team
3. Create a vision and plan for change
4. Communicate the changed vision and plan with stakeholders
5. Enable action by removing barriers to change
6. Generate short-term wins
7. Build on the change
8. Anchor the change in the organizational culture 

To the following scenario.

The advanced nurse practice council (Team group members are core) has been assigned to represent the nursing division in a collaborative innovation project between WSU Hospital and the State of Washington Health Department.

Based on aggregate data, the two entities have determined chronic disease management initiatives are critical to the diabetic population at-large.

The “collaborative” has been asked to present a proposal to key stakeholders at next month’s Board of Director’s meeting.

The proposal will integrate components of analysis, strategic planning, and leadership implementation for a care coordination process.

Elements to include:

A collaborative Care Coordination Clinic

Data Collection and Analysis

Quality Improvement

Policy Development

Data Interoperability

EHR

*Details under Assignments and Assessments.

Refer to Group Exercise Grading Rubric

Dedicated Group Exercise Work Session

Teams will present project #3 in a

Live Group Presentation Week 14 & 15 Synchronous ZOOM Class

Due by Sunday of Week 14 by 1159pst

Read:

Teisberg, Elizabeth PhD; Wallace, Scott JD, MBA; O’Hara, Sarah MPH. Defining and Implementing Value-Based Health Care: A Strategic Framework. Academic Medicine 95(5):p 682-685, May 2020. | DOI: 10.1097/ACM.0000000000003122

Wolf, A., Erichsen Andersson, A., Wikström, E., & Bååthe, F. (2024). Untangling the perception of value in value-based healthcare – an interview study. International Journal of Health Care Quality Assurance Incorporating Leadership in Health Services, 37(5), 130–141. https://doi.org/10.1108/LHS-07-2023-0051

Lecture in Canvas will discuss the elements of

Care Coordination and the paradigm shift to the Value-Based Care Model.

Financial Principles to inform fiscal planning and Management 

Read:

Dunn (2021); Part VII

Chapters 25 &26

Fundamental of Control and the Controlling Function

Budgetary and Control Techniques

Lecture in Canvas

Financial Management Skills for Nurse Managers

https://www.nursingworld.org/content-hub/resources/nursing-leadership/nursing-financial-management/

Homauni, A., Markazi-Moghaddam, N., Mosadeghkhah, A., Noori, M., Abbasiyan, K., & Jame, S. Z. B. (2023). Budgeting in Healthcare Systems and Organizations: A Systematic Review. Iranian journal of public health, 52(9), 1889–1901. https://doi.org/10.18502/ijph.v52i9.13571

As noted in the above resource articles, nurse managers are often responsible for participating in the organization’s overall budget development, as well as department or division specific budget

and resource funding. Healthcare budget development is highly complex and requires extensive nurse involvement and collaboration to ensure fiscal solvency. The operating budget ensures funds are stable and available to pay for salaries, overtime, education, training, and contract staffing. The capital budget secures large purchases, durable goods, and on-going technology investments and equipment upgrades. While nurse manager’s do not control payments to the hospital, they are responsible for controlling costs and expenditures within their department or cost center’s budget.

Synchronous Class via Zoom

Live Group Presentation #3

Transforming Patient and Population Healthcare Outcomes

"Health Equity Should Be A Key Value In Value-Based Payment And Delivery Reform", Health Affairs Blog, November 25, 2020. DOI: 10.1377/hblog20201119.836369

Watch: “What if our Healthcare System

Kept Us Healthy/” Rebecca Onie.

https://www.ted.com/talks/

rebecca_onie_what_if_

our_health_care_system_kept_

us_healthy

Practicum Reflection #3 Due 

Synchronous Class via Zoom

Live Group Presentation #3

And Power Point Presentation

95-100