Fall 2012

NURS 7311-001 Theories and Research in Leadership, Quality, Safety, and Evidence Base

 

First day of class, August 30, 2012, 4p - 7 p, Room 1.102

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FACULTY CONTACT INFORMATION

Deborah Kendall-Gallagher, JD, PhD, RN
E-mail:  KendallGalla@uthscsa.edu
Office Phone:  (210) 567-5843
Office Fax:  (210) 567-1719
Office Room:  NSG 2.670
Office Hours:  By appointment

Eileen Breslin, PhD, RN, FAAN
E-mail:  Breslin@uthscsa.edu
Office Phone:  (210 567-5800
Office Fax:  (210) 567-5929
Office Room:  NSG 2.204B
Office Hours:  By appointment

COURSE DESCRIPTION

This course focuses on leadership in complex adaptive systems as a foundation for leading and supporting practice-based improvement using evidence based frameworks to inform and shape health care improvement.  Microsystems, mesosytems, and macrosystems and their impact on healthcare quality, cost, and patient outcomes will be explored.  Exposure to state and federal health policy trends, interprofessional health care perspectives, strategic planning, and evaluation are essential for leading and achieving a patient-centered healthcare system that produces better care, better health, and lower costs.

CREDIT AND TIME ALLOCATION

Credit Hour Allocation: 3 Semester Credit Hours
Clock Hour Allocation: 3 Clock Hours Class (45 hours class)

PREREQUISITES

Graduate Standing

COURSE OBJECTIVES

  1. Assess personal leadership styles.
  2. Analyze the science of leadership in multiple contexts.
  3. Analyze healthcare delivery as a complex adaptive system.
  4. Apply tools/activities used to promote creative thinking and predict innovation adaptation to transform the healthcare delivery system.
  5. Compare and contrast creativity and innovation
  6. Describe how microsystems, mesosystems, mesosystems, and  macrosystems interact to impact quality, cost, and patient outcomes.
  7. Analyze mechanisms to translate evidence into practice, make policy, transform healthcare organizations, and shape health policy.
  8. Critique strategies for evaluating performance and sustaining  improvements.

CLINICAL OBJECTIVES

N/A

CRITERIA FOR EVALUATION / GRADES

Assignment 1 – Reflective  Journal (25 points possible)

Each week read the assigned chapters in  Deep Change (Quinn, 1996) and complete  one question in Personal Steps to Change and one question in Organizational Steps to Change listed in the end of chapter reflections.  Grading criteria for the weekly reflective assignments are outlined in the reflective journal expectation rubric .  For weeks 1-13, you may receive a maximum of 1 pt per journal reflection with a total of 2 points for Week 14 and 10 possible points for Week 15.    We are looking for insight, understanding and synthesis informed by the 10 strategic thinking skills (Horwath, 2011, p.14/15). 

***Note Rubrics are found within the blackboard course, click on Course Content and then Course Information 

Assignment 2 - Class Participation (50 points possible)

Each week complete the required learning activities inclusive of readings, writing assignments, online and in-class discussions.  Grading criteria and Levels of Achievement for class participation are described in the Participation Expectation Rubric .   You will receive written feedback regarding Level of Achievement mid-semester.    

***Note Rubrics are found within the blackboard course, click on Course Content and then Course Information  

Assignment 3 - Oral Presentation (25 points possible)

  1. Student will present the executive summary (10 minutes each).
  2. Oral presentation will be graded on the following criteria:
    1. Design of strategic plan
    2. Appropriate use of data to support strategy   
    3. Clarity of alignment of goals across micro, meso, and
      macro levels of organization
    4.  Leadership actions designed to facilitate successful implementation of plan

Weighting of assignments;
Assignment 1 - 25% of grade - Reflective journal as per rubric
Assignment 2 - 50% of grade
Assignment 3 - 25% of grade

Grading Scale
A= 90-100%
B= 80-89%
C=70-79%
D=60-69%
F=Below 60%



CLASSROOM ATTENDANCE

Attendance in class is an expectation of each student.

APA GUIDELINES

Effective Fall 2010, the APA Publication Manual 6th edition is required for use in all nursing school programs.

SCHOLASTIC DISHONESTY

Students are expected to be above reproach in all scholastic activities. Students who engage in scholastic dishonesty are subject to disciplinary penalties, including the possibility of failure in the course and dismissal from the university. "Scholastic dishonesty includes but is not limited to cheating, plagiarism, collusion, and submission for credit of any work or materials that are attributable in whole or in part to another person, taking an examination for another person, any act designed to give unfair advantage to a student or the attempt to commit such acts." Regents Rules and Regulations, Part One, Chapter VI, Section 3, Subsection 3.2, Subdivision 3.22.

ADA ACCOMMODATIONS

Any student seeking ADA Accommodations under the American with Disabilities Act should contact the Associate Dean for Admissions and Student Services within the first week of the semester so that appropriate accommodations may be arranged. A Request for Accommodations (Form 100) must be completed. These forms are available in the Office for Students Room: NS 1.106. 

REQUIRED TEXT / REFERENCE

 

*** Additions to reference maybe added

Beauchamp, T.L. & Childress, J.F. (2009). Principles of biomedical ethics (6th ed). NY, NY: Oxford University Press.  ISBN 13: 978-0-19-533570-5

Bick, D. & Graham, I.D. Evaluating the impact of implementing evidence-based practice. Sigma Theta Tau International Honor Society of Nursing. Wiley-Blackwell.  ISBN 978-1-4051-8384-0

Nelson, E.C., Batalden, P.B., Godfrey, M.M. et al. (2011). Value by design. Developing clinical microsystems to achieve organizational excellence. San Francisco, CA: Jossey-Bass.  ISBN 978-0-470-38534-0

Goldstein, J., Hazy, J.K. & Lichtenstein, B.B. (2010) Complexity and The Nexus of Leadership: Leveraging Nonlinear Science to Create Ecologies of Innovation.  USA: Palgrave Macmillan  ISBN 978-0-230-62227-2

Heifetz, R.A. (1994). Leadership without easy answers. Cambridge, MA: The Belkap Press of Harvard Press University. ISBN 0-674-518-6

Horwath, R (2009). Deep Dive. Austin TX: Greenleaf Book Press. ISBN 978-1-929774-82-1

Kent, B. & McCormick, B. Clinical context for evidence-based practice. Sigma Theta Tau International Honor Society of Nursing. Wiley-Blackwell.  ISBN 978-1-4051-8433-5

Ramo, J. (2009). The Age of the Unthinkable.    New York NY : Back Bay Books/Little, Brown and Company.  ISBN 978-0-316-11811-8

Rycroft-Malone, J. & Bucknall, T. (Ed.). (2010). Models and Frameworks for Implementing Evidence-Based Practice:  Linking Evidence to Action. Sigma Theta Tau International Honor Society of Nursing. Wiley-Blackwell.  ISBN 978-1-4051-7594-4

Quinn, R.E. (1996). Deep change: Discovering the leader within. San Francisco, CA: Jossey-Bass. ISBN 0-7879-0244-6

Vergenti, R (2009). Design Driven Innovation. Boston, MA: Havard Business Press. ISBN 978-1-4221-2482-6

Yukl, G. (2010). Leadership in Organizations. (7th Ed.) Upper Saddle River NJ: Prentice Hall.  ISBN 978-0-13-242431-8

RECOMMENDED (OPTIONAL) TEXT / REFERENCE

 



Bryson, J. (2011) Strategic Planning for Public and Nonprofit Organizations: Jossey-Bass. ISBN 978-0-470-39251-5

Bryson, J. (2011) Creating Your Strategic Plan: A workbook for public and nonprofit organizations. Jossey-Bass. ISBN 978-0-470-40535-2

Doran, D.M. (2011)  Nursing Outcomes: The State of the Science. (2nd Ed). Sudbury MA: Jones and Bartlett Learning.  ISBN 978-0-7637-8325-9

Feldt, G. (2010). No Excuses: 9 Ways Women Can Change How We Think About Power. Berkley CA: Seal Press.  ISBN 978-1-58005-328-0

Kane, R.L. (2004). Understanding Health Care Outcomes Research. Sudbury MA: Jones and Bartlett Publishers. ISBN 0-7637-2628-1

Kleinpell, R.M. Editor (2009). Outcome Assessment in Advanced Practice Nursing (2nd Ed.). New York NY: Springer Publishing Company. ISBN 978-0-8261-2583-5

Lindberg, C., Nash, S. & Lindberg, C. (2008). On the Edge: Nursing in the Age of Complexity.  Bordentown NJ: Plexus Press.  ISBN 1438246765

Wheatley, M.J. (1992, 1994) Leadership and the New Science: Learning about Organization from an Orderly Universe. San Francisco CA: Berrett-Koehler Publishers Inc. ISBN 1-881052-44-3

 

CONTENT OUTLINE

 

I.                    Unit I  Leadership

1.       Know Thyself

2.       Know the System (overview of health care delivery system)

3.       Know the Science

4.       Know the Tools

                                                              i.      Innovation and Creativity

                                                            ii.      Strategic Planning

II.                  Unit II  Practice-Based Improvement in Quality and Safety

1.       Health Care System as a Complex Adaptive System

                                                              i.      The Institute of Medicine Quality Reports

                                                            ii.       The Economic/Quality Imperative

2.       National Strategy for Improvement

                                                              i.      The Triple Aim

1.       Mechanism for Achieving Triple Aim

a.       The Affordable Care Act

                                                                                                                                      i.      Value-Based Care 

                                                                                                                                    ii.      Expand Insurance Coverage

                                                            ii.      Emerging Models for Delivering Care

1.       Science of Teams

2.        Accountable Care Organizations

3.       Patient-Centered Medical Homes/Nurse Managed-Clinics

4.       State Single-Payer

III.                Unit III  Moving Towards a New Framework for Evidence-Based Practice

1.       Evidence-based frameworks for Knowledge Translation

2.       Science of Improvement

                                                              i.      Organizational Improvement Frameworks 

1.       Malcolm Baldrige Criteria

2.       The Dartmouth Institute of Clinical Microsystems

3.       Lean/Six Sigma

                                                            ii.      Measuring System Performance

1.       Role of Performance Measurement in Improving Quality

2.       Balanced Scorecard

3.       Science of Implementation

                                                              i.      Model for Understanding Success in Quality Improvement (MUSIQ)

Framework for Evaluating Impact of Evidence-Based Practice

CALENDAR - 1st Day Only

Please check the schedule for recent updates on Class Dates & Room.

 

Dear Students,

      Apologies for not getting this to you on Friday. We hope you had a great weekend.  Welcome to the UTHSCSA Doctor of Nursing Practice program.  Dr. Kendall-Gallagher and I are thrilled to be teaching your first course, Theories and Research in Leadership, Quality, Safety, and Evidence Base. Here is the course syllabus and the first week’s assignments. You may want to bring your laptops to class so we can be sure your questions regarding Blackboard are answered.  Happy reading and look forward to seeing you.  For the first day of class please read/complete and be prepared to discuss the following:

1. Ramo, J. (2009). The Age of the Unthinkable.   New York NY : Back Bay Books/Little, Brown and Company.  [please read entire book] 

2. Heifetz, R.A. (1994). Leadership without easy answers. Cambridge, MA: The Belkap Press of Harvard Press University. [Please read Forward, Introduction, and Chapter 1& 2] 

3. Complete and be prepared to share your results from the Kingdomality quiz found at http://www.cmi-lmi.com/kingdomality.html

     This class is highly participative and requires weekly class readings and reflective journaling.   We look forward to seeing you and thank you for attending Thursday evening.

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