摘要:

This article provides an overview of the American health care system operations within the context of the transition from the industrial to the information/technology age. According to Francis Fukuyama, this transition has forever changed the trust relationship between organizations and employees. Trust is a necessary component of our everyday lives and, in an organizational sense, trust is the precursor to shared values. The degree to which personal and organizational values are shared is what gives an organization its social capital. In order for an organization to be successful, it must be rich in social capital.

ISSN:0363-9568    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Organizations thrive when employees trust each other. Nurses are facing significant challenges in providing patient care services and creating the systems to support the desired care. The volatility resulting from exploding technology, mergers, and acquisitions undermines once trusting relationships. Issues of mistrust emerge from the unstable reimbursement models, increased government regulations, and a shortage of qualified caregivers. Adversarial relationships abound with union activity, legislative efforts to manage staffing, work hours, and patient acuity systems.

ISSN:0363-9568    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Trust is the mechanism through which relationships are built and maintained. Relationships are the means through which organizations conduct their work as virtual or actual health care environments. Three nursing staff members, a Director of Patient Services, a Clinical Nurse Specialist, and a Staff Nurse, examine their perceptions of the ways trust, mistrust, and betrayal may occur during turbulent times of transition and change. They describe the ways in which trust can be strengthened and betrayal avoided or minimized as the system expands its mission, scope of work, number of personnel, and complexity of communication.

ISSN:0363-9568    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

In trusting health care organizations or organized delivery systems (ODSs), nursing personnel are involved in evaluating the performance competence of their Chief Nurse Executive (CNE). As ODSs increase in numbers and expand geographically, new approaches must be developed to assess the ways in which CNEs perform to ensure accountability. This article presents the results of a preliminary pilot study that describes a data collection instrument to assess the performance competence of a CNE in an ODS. The qualities of the data collection instrument are reported with illustrative items from the developed standardized protocol and with recommendations for future use.

ISSN:0363-9568    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Chief Nurse Executives (CNEs) are increasingly providing leadership in integrated health care systems or organized delivery systems (ODSs). An ODS provides coordinated care services to populations to which nursing is held clinically and fiscally accountable for health status and outcomes. This descriptive study uses an innovative approach, Appreciative Inquiry (AI), to examine performance competencies that nurses expect of a CNE in an ODS. These are different from competencies expected in a single organization, but have yet to be identified and described. Results suggest that while expectations may vary among an ODS's entities, it is possible to co-create CNE trust and performance competencies for the new organizational structure.

ISSN:0363-9568    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Mutual trust between the Chief Nurse Executive (CNE) and a regional nursing staff enabled the creation of a shared vision of excellence in clinical outcomes in Aurora Health Care—Metro Region, an organized care delivery system in Eastern Wisconsin. Motivation, leadership skill development, and a responsive environment to develop self-efficacy related to staff nurses' leadership behavior use have been provided to the clinical nursing staff since 1995. This article describes the conceptual model of shared leadership development and summarizes the findings from a research program that demonstrated that implementation of a shared leadership concepts program in an organized delivery system increased staff use of leadership behaviors, professional nursing practice autonomy, and improved patient outcomes.

ISSN:0363-9568    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Over the years, nursing departments have used a shared governance approach in organizing services and functional areas. The article describes how nurse executives have overcome potential conflicts among their ranks during the restructuring of a healthcare system. Organized as a council to oversee the clinical, administrative, research and educational areas of nursing practice, nurse executives learned to work as a group and developed trusting relationships as they collaborated in implementing performance improvement initiatives.

ISSN:0363-9568    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Objective: To examine the level of system integration and determine if a relationship exists between the level of nursing development and system integration. Data Source/Study Setting: Primary data was collected from Nurse Administrators in Maryland acute care hospitals in December 1999. Study Design: A survey of Maryland nurse administrators was conducted utilizing three tools. The Perceived Systemness and Integration Measure was used to measure the level of integration within the system or network. The level of professional practice development was measured utilizing a Likert-scale tool designed by the researchers based on the Transformational Model for Professional Practice in Health Care Organizations. A narrative response questionnaire was included to determine mechanisms in place to promote professional practice and clinical integration. Findings: The level of system integration was moderate in all domains: Functional (3.35), Physician-System (2.88), and Clinical (3.14). Significant correlations were found between Transformational Leadership and Culture (.539, p < .05), Strategic Planning (.514, p < .05), and Resource Allocation (.505,p < .05). No significant relationship was found between the level of clinical integration and the development of nursing. Conclusions: The level of clinical integration was moderate. Few mechanisms to enhance clinical integration exist across the delivery system. Nurse executives need to promote structure and processes to enhance the development of nursing in integrated systems and networks.

ISSN:0363-9568    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Used correctly, informational technology can be key to building trustworthy organizations. This article examines the concept of trust as it relates to three key stakeholders: patients, caregivers, and payers. Each has different issues regarding trust; information systems can support these issues to create an atmosphere of trust within a health care organization.

ISSN:0363-9568    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:0363-9568    

出版商:OVID    

年代:2002

数据来源: OVID